Keen Giving Program Application 


HabitAware is committed to ending the stigma around Body Focused Repetitive Behaviors (BFRB) and getting help to those in need. We want to give back to our BFRB community and help eliminate financial barriers for individuals who may benefit from a Keen bracelet. 

To apply, please complete the form below. Incomplete applications and multiple submissions will not be considered. Applications are reviewed on a rolling basis, and selections are made rolling as well. Please note that we will only notify chosen recipients due to the volume of applications we receive.

If chosen, the HabitAware team will contact you via email with additional information. If you agree to participate, we'll take your shipping information and color/size preference for your one Keen Sporty bracelet. (A second Keen can be purchased at a subsidized price.) 

Applicants must be 18 years or older. If under 18, please ask a parent or guardian to apply on your behalf. 

Your Name *
Your Name
Relationship to applicant
Nominee Name
Nominee Name
(If different from "Your Name" above)
For which behavior(s) will the Keen be used? *
Choose one social media account to share with us and paste its URL here. If you are a minor, or don't use social media, just write "n/a" below.
Short essay questions
Please respond within the word count range. Pro tip: draft your answers in a separate document and paste here when you are ready to complete the form!
100-200 words. (BFRB stands for body focused repetitive behavior - things like hair pulling, skin picking, nail biting, nose picking, etc.)
100-200 words
100-200 words Please use this space for any additional information that you would like the HabitAware team to consider.
Words are cool, but we'll give preference to video submissions, so share your unlisted Youtube link here. (Vimeo and other video-hosting sites are accepted too.)
Permissions
Please review the application before submitting
By submitting the application, I acknowledge that I have completed the application truthfully and to the best of my knowledge.