Application Form

Name

First Last

Location: City/State/Region, Country

Job title and organization, if applicable

Any websites or web presence related to you and/or your organization’s work

For the following questions, you have the option to write out your answers or record and upload a video of your answers below.

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Short bio describing your social change work and some of your life experiences that inform that work (200 words)

How does your work currently or have the potential to impact systems and shift the distribution of power or resources? (200 words)

What opportunities do you see for individual donor philanthropy to greater support frontline leaders working in movements for justice? What can individual donors do differently to use their power and influence in support for systems change work such as yours? (200 words)

Based on your answer above, how would these changes in philanthropy impact you and the communities and movements you work with? How would a reimagined philanthropy enable you to do your work better and produce different outcomes?

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