Ella, Inc. Workshop Application Form

Application Form
DISCLAIMER:

To participate in Stage 1 of the Ella, Inc. Social Impact Workshop, applicants MUST meet the following requirements.
- Be between 15 and 19 years of age (by June 2025).
- Possess a valid visa and passport at the time of the application
- Have a strong command of English (minimum ESOL level 2).
- Participation in community-based social impact project service hours is optional but will be considered favorably in the acceptance process.
- Commit to attend all three days of the workshop.
- If selected as one of the Top 3 Pitch Competition Finalists and wishes to advance to Stage 2 / Ella, Inc. Camp in Miami, the participant will be responsible for paying all round-trip travel expenses to/from Miami, FL—USA.
Your Name*

First NameLast Name
Parent/Guardian Name*

First NameLast Name
Your Email*
You will receive all the information about the program on this email
Parent/Guardian Email*
example@example.com
Your Number*

Country CodeArea CodePhone Number
Parent/Guardian Number*

Country CodeArea CodePhone Number
Your Birthdate*

MonthDayYear
Date
Which city do you currently reside in?*
School/Organization Name*
What grade level are you currently in?

9th grade: freshman10th grade: sophomore11th grade: junior12th grade: seniorOther
Select the Host Country of the Workshop*
How did you find this program?*
Have you previously participated in social impact activities? If yes, describe those activities and what did you learn from them.*

0/200
If accepted into the Ella, Inc. Workshop, please share 3 objectives you hope to achieve through the program.*

0/200
If you were asked to address the most critical issue or the biggest gap in your community, what would it be? Describe a significant social impact strategy you would implement to help resolve this issue.*

0/300
Have you previously participated in any Ella, Inc. Social Impact Workshops.*

0/300
Photo of Your Visa*

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Photo of Your Passport*

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Applicant Certification and Media Release

I hereby confirm that the information provided in this application is accurate and truthful. I understand that any false information or failure to meet the eligibility criteria may result in the forfeiture of my seat or scholarship opportunities. Additionally, I grant permission to the Casimiro Global Foundation to use photographs of me taken by their staff for use on their website, social media, promotional materials, and media releases.
EIW Candidate Signature*

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Parent of Candidate Signature*

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Should be Empty: