1IN25 Warrior Application

1IN25 Warrior Application

Please complete this form to be considered for our Warrior of the Month.
Each month we create a new warrior collection to raise awareness, build community and collect some dollars to support someone living with Epilepsy.

If selected, we will help you build your village to surround you with support. Also, $5 from every tee sold from your collection will go directly to the bank account you specify (in one lump sum at the end of the month**) to be spent how you need to spend it.

To start/continue the conversation about epilepsy, and specifically your epilepsy journey, it's imperative that you share content (ours and yours) on your socials and with your friends and family. This way you can reach the people that will matter most in building your village. We'll share your story, and your tee on our socials too.

Please note at this stage we can only accept applications for families living in Australia.
** Please allow up to 10 working days after your fundraiser ends for money to clear in your account.
Name of person completing the form*

First NameLast Name
Email*
example@example.com
Social media handles (eg. "Insta: @epilepsywarrior33; Tiktok: epilepsyqueenbee)"*
Name of warrior (if it's you just write 'As above')*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Epilepsy Type*
Date of diagnosis (if exact date unknown please use 01/01/YEAR)*

MonthDayYear
Date
Age at time of diagnosis*
Age now*
Please share your story with us!

Ideas for points to cover:
- describe the first seizure
- how did you find out it was epilepsy?
- describe the diagnosis, how has that changed your life?
- what does daily life look for you?
- what are some lessons you've learned?
- any advice to others?
- Describe your/your warrior's personality
- How are you/your warrior doing now?
- Tell us some of your/their favourite things in life
Your story - aim for a minimum of 300 words if possible*
Bank details (Bank, Account name, BSB, Account number) where we'll transfer your tee proceeds*
If you would prefer to donate this to 1IN25 or another organisation, please let us know here
Please share 3-5 images of you/your warrior*

If you're not comfortable sharing your (warrior's) face on social media, they can be facing away from the camera. Otherwise you could share photos that represent your Epilepsy journey.
Cancelof
Which three words best describe you/your warrior? *
Eg. Strong, brave, resilient. We'll use these words to create your tee!
Would you like to add "Supporting NAME" to the design? (Eg. Supporting Katie)*

YesNo
If yes, which name would you like us to use?
(eg. first name or a nickname)
Would you like us to add your warrior's story to our blog? It will remain on our website so if you ever have fundraisers or a gofundme etc we can link it for you.

Yes, please!No thanks!Other
By submitting this form you are consenting to 1IN25.co creating a collection that will support you/your warrior and you allow us to share your story and the photos you have submitted to us. We will only use the first name of your warrior in our campaign and on social media.

Please only enter information you are comfortable with us sharing.

To build both awareness and your village, it's imperative that you post about your tee and your journey on your socials. Please only submit this application if you can commit to sharing posts and stories on your own social media accounts (our content and your own). We will add you as a collaborator on some posts on Instagram to make this as easy as possible for you.
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