Become an Ally

�� Thrive��Ally

�� Thrive Allies are community mental health and wellness providers who register as available to provide free services to an impoverished �� student. (Providers interested in offering a combination of free and discounted services for �� students may register as both an �� Thrive Partner and with the OwlPerks Card Program).

Please visit /thrive/legal/��for important legal information prior to filling out the form.

To register as a Thrive Ally, please complete this form:

Become a Thrive Ally

Provider Name

Business/Practice Name

Business/Practice Address

Email *

Practice Phone Number

Approval to link to your website *

Yes

Website address

About your practice/business (highlight specialty areas in two to three short sentences):

Are you an Alumni of ��?

Yes

Agreement to legal terms listed at http://fau.edu/thrive/legal *

Yes

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