Bessie Lee’s New Experience Application Name * First Name Last Name Date of Birth * MM DD YYYY Email * Phone * (###) ### #### How did you hear about us? Option 1 Option 2 Why do you want to participate in the program? (500 words or more. Please provide a detailed explanation.) * What are your goals for this program? (500 words or more. Please provide a detailed explanation.) * Explain why this program is important to you and how it will help you achieve your goals. (500 words or more. Please provide a detailed explanation.) * Thank you!