Upswell Chicago Fellowship Application
Please complete the form below and click SUBMIT. Information will not be saved until you submit the application.
Applicant Information
First Name
*
Last Name
*
Organization / Company
*
Organization Type
*
Academic Center
Charitable/Nonprofit Organization
Corporate Giving Program
For-profit Organization
Foundation - Community
Foundation - Corporate
Foundation - Operating
Foundation
Government
Media
Social Enterprise/Benefit Corporation
Other
Not affiliated with an Organization
Job Role
*
Head of Org
C-Suite/Senior Level
Managerial Level
Entry Level
Other
Job Title
*
Address
*
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Country
*
Phone Number
*
Email
*
Gender
*
Female
Male
Non-Binary/Third Gender
Prefer Not to Say
Prefer to self-describe
Describe gender here.
Do You Identify as Transgender?
*
Yes
No
Prefer Not to Say
Sexual Orientation
*
Straight/Heterosexual
Gay or Lesbian
Bisexual
Prefer to self-describe
Prefer not to say
Describe sexual orientation here.
Race/Ethnicity
*
American Indian or Alaska Native
Asian
Black or African American
Hispanic, Latino, or Spanish origin
Middle Eastern or North African
Native Hawaiian or Other Pacific Islander
White
Biracial/Multi-Racial
Prefer Not to Say
Other
Please indicate the category you identify with most.
Describe race/ethnicity here.
Date of Birth
*
/
Month
/
Day
Year
Date
The following questions will help us better understand your needs at Upswell.
Accessibility and Accommodations: Pursuant to the Americans with Disabilities Act, please check all that apply:
I will need materials provided in a different format. (Large print, Braille, audio-only, etc.)
I will need American Sign Language (ASL) interpreting.
I use a mobility device. (Walker, wheelchair, etc.)
I will be accompanied by a service animal.
Other
Dietary Needs
Kosher
Halal
Vegan
Vegetarian
Other
How did you hear about Upswell?
IS Website
IS Email
Facebook
Funder/Foundation
Twitter
LinkedIn
Instagram
Personal recommendation
Past Upswell or Independent Sector conference attendee
Print/broadcast advertising
Other
If you were encouraged to apply for the Upswell Fellows by a funder, please include the name of the organization here.
If you could connect with anyone at Upswell, who would it be? (for example: peers who work in similar locations on issue areas or that face a similar challenge)
Fellowship Application Questions
The following questions will be used to determine your eligibility for an Upswell Fellowship. Please answer the questions below:
How are you/your organization engaging unlikely partners in order to build a society where all can thrive?
*
What motivates and compels you to do your social change work?
*
What do you hope to uniquely contribute to the Upswell community?
*
Which travel statement applies to you?
*
I am traveling from outside the Chicago-metro area and will need flight and hotel provided as part of my Fellowship.
I am from the Chicago-metro area and will need hotel as part of my Fellowship
I am from the Chicago-metro area and will not need hotel or travel as part of my Fellowship.
Other
Resume
Please, upload your resume as a PDF file OR provide your LinkedIn profile. This is a mandatory requirement.
Resume
Browse Files
Cancel
of
LinkedIn Profile
Copy & paste web address. You may also download your LinkedIn profile and upload it as a PDF file.
Email Preferences
SUBMIT
Org. Budget Size
Should be Empty: