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Blue Spruce
Active Aging Foundation
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Apply for Blue Spruce Active Aging Scholarship Funds
First name
*
Last name
*
Email
*
Address
*
Age
Annual Household Income
Marital Status
*
Single
Married
Cohabitating
Divorced
Widowed
Number of Dependents
*
0
1
2 or more
Employment Status
*
Full time
Part time
Unemployed
Retired
Other
How would you describe your current lifestyle and activity level?
*
Mostly sedentary (less than 30 min per week of movement)
Somewhat sedentary (between 30 min and 1 hour per week of movement)
Somewhat active (between 1 and 3 hours per week of movement)
Fairly active (between 3 and 7 hours per week of movement)
Very active (more than 7 hours per week of movement)
Any additional information and/or circumstances you would like us to consider while reviewing your application?
Submit
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