Application Form

Complete our form to apply to join the SHB program. Be coached to a life of freedom and no holding back!

ABOUT YOU
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MORE ABOUT YOU
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LIFE AT WORK
*If you are currently unemployed please skip this section of the form.
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LIFESTYLE
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ABOUT YOUR STUTTERING
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I generally stutter when I…
Which of the following speaking behaviors do you often feel you do?
TRUE OR FALSE TEST

Directions:

Choose TRUE for each statement that is true or mostly true for you and choose FALSE for each statement which is false or not usually true for you.

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FAMILY AND SOCIAL RELATIONSHIPS
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YOUR SUPPORT NETWORK
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