Inaugural Fellowship Application
Name
Prefix
First Name
Middle Name
Last Name
Suffix
E-mail
example@example.com
Phone Number
-
Area Code
Phone Number
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
In one sentence, what does it mean for you to defy gentrification?
What elements of faith, self-care, and creativity do you hope to get from participating in this program?
How do you practice community care, build infrastructure, provide access, and facilitate convenience. Or, what are your needs to be able to do these things for your community?
This program is tuition-based and that tuition for our inaugural cohort is $5,000, with monthly payment plans and scholarships available. How would you be able to pay? (Note this does not affect your ability to be accepted, nor do you need to submit anything else to be considered for a scholarship).
Please Select
No, I need a scholarship
Yes, with a payment plan
Yes, I need to ask for my organization to pay
Yes, I can pay in full
That's it. Look for an email after you submit, and a call to let you know if you've been accepted into the inaugural round. If you didn't get in this time, don't worry; I have your information, and I will review it for our next rounds.
Thank you for your submission!
Submit
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