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1. Full Name (Required.)

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2. Email address (Required.)

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3. Did you receive an EPIC Cloré subsidy in 2025? (Required.)

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4. What do you require a subsidy for? (Required.)

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5. 1If you are applying for EPIC Leadership 1:1 Coaching, how many coaching sessions are you seeking a subsidy for?

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6. If you are applying for a Peer-to-Peer Support Cohort subsidy, which cohort are you currently in? (Required.)

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7. What is your organization's operating budget?

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8. How much of the fee subsidy are you applying for? (Required.)

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9. How will receiving this subsidy support your leadership development and capacity building? (Required.)

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10. How do you plan to cover a portion or all of the membership or program fee in future years? (Required.)

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11. Please upload financial documentation to support your application (i.e. a budget that demonstrates you have a limited or non-existent budget for professional development. (Required.)

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