Welcome! We are thrilled you are choosing Elevate!  If you are ready to dive in, please complete the application below.  

We strive to process all applications within 3-4 business days, so keep an eye on your email! 

All information received from Elevate, online trainings or RBI, is copyrighted and cannot be replicated or used without written consent of RBI Management.

Further, you acknowledge during the course of participation with RBI and Elevate you will have access to materials, information, curriculum, trade secrets, clients, confidential data, and good will, which you agree to retain as confidential, and not use said information for any other means.

By submitting this application you hereby agree not to directly, or indirectly, compete with the Elevate program or RBI.

Today's Date *
Today's Date
Name *
Phone *
Date of Birth *
Date of Birth
This can include anything at all about yourself, your experiences, current struggles and/or needs.
Marital Status *
Do you have access to the internet with a laptop or tablet? *
RBI may use photos to advertise Elevate and it's programs. This would be done with the utmost taste to protect each Survivor participant. Please choose an option below to indicate your preference for the use of your likeness *
Often times, we want to advertise this program to encourage others to join. This would not include confidential information, personal information, nor parts of your story, etc., but rather positive quotes you have conveyed about RBI and it's programs *
Please be advised, all materials and information shared through RBI, Elevate Academy, our publications, or websites, written or verbal, is for informational purposes only, and shall not be construed as either medical or mental health treatment, nor does your participation in such establish a therapist-client relationship. Our staff are not credentialed medical nor mental health professionals. In addition, any information obtained, either written or verbal, shall not be considered a substitute for professional consultation or care. *
RBI reserves the right to refuse service to anyone. RBI does not discriminate in its educational programs or activities on the basis of race, color, national or ethnic origin, ancestry, age, religion or religious creed, disability or handicap, sex or gender. *
In consideration for being allowed to participate in RBI activities or other opportunities brought up through RBI, I release from liability and waive my right to sue RBI, their employees, or volunteers from any and all claims, including claims of RBI negligence, resulting in any physical injury, illness (including death) or emotional stress I may suffer or which may be a result from my participation. *
OPTIONAL SCHOLARSHIP REQUEST: If financial assistance is needed, please complete the next section.
RBI believes every survivor should have the opportunity to benefit from Elevate Academy. While we cannot fully scholarship everyone, we desire to assist when possible. If you know you will need assistance to be able to participate, please complete the section below. We have also included a customizable sponsor letter template on the Elevate page designed to explain the program and assist you in obtaining a sponsor.
Which of the following best fits your situation? *
My Investment Amount *
Indicate the amount you can pay monthly without assistance. Please choose ALL that apply. I can invest.......

Upon clicking 'submit' click on the membership of your choice to complete enrollment in ELEVATE!