Consent to submit this application and privacy policy

Thank you for your interest in applying for a discounted membership with The Center for Mindful Eating. Your privacy is important to us. We are asking for your name and contact information to process your application. Your responses will be shared with The Center for Mindful Eating Board of Directors, volunteers and staff.

Per Survey Monkey's terms of use, any personal data collected from you in this survey may be transferred to various countries, including the United States and other locations SurveyMonkey has offices. Please see SurveyMonkey’s Privacy Policy and Security Statement for further information.

Question Title

* 1. Do you consent with your personal data being processed as described above? You must click Yes in order to take the survey.