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Become A Mental Health Luminary
First Name
Last Name
Email address
Contact Number (active on Whatsapp)
Share postal address (this is for sending over the Luminary Welcome Package to you!)
Please select your Gender
Male
Female
Transgender
Non-Binary
Prefer not to say
Please select your Pronoun
he/him
she/her
they/them
Share links to your Instagram, Facebook and YouTube channel
Which category you often promote other brands?
Health and Fitness, Yoga
Lifestyle - Beauty, Fashion, Luxury
Artist - Musician, Dancer, Writer, Painter
Parenting, Female centric content
Travel
Finance, Technology
Photography (any genre)
Who is your target audience?
Women
Men
LGBTQI+
Not specified
What age group best represents your followers?
Under 18
18 - 24
25 - 34
35 - 45
45 +
Have you partnered with a Mental Healthcare Initiative before?
Yes
No
Would you like to share your personal experience with mental health through this program?
Yes
No
Maybe
At last, do share with us why you'd like to be one of our Luminaries who are bringing a change into the world of mental health care!
Send