Out With It Global Challenge Innovator Profile

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Out With It: The MSMGF Pre-Meeting at AIDS2018 is a unique opportunity to make your ideas a reality. We are seeking community-led solutions to global challenges facing young gay and bisexual men around the world.

6-8 proposals will be selected to attend and help facilitate our pre-meeting and a select few will be chosen at the event to go on to a stage of pilot development after our meeting.

In addition to submitting a 2-3 minute video explaining your proposal, please use this form to create a profile for you and your team members as part of your application.

In order to be eligible, your team must be:
·      youth-led (mostly under the age of 30);
·      have at least two members that will be able to attend the MSMGF Pre-Meeting in Amsterdam on July 22nd; and,
·      be able to present in English at the MSMGF Pre-Meeting.

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* 1. Primary Applicant

Full Name *

Organizational Affiliation

Country of Residence *

Email Address *

Phone Number

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* 2. Primary Applicant (Date of Birth)

Date / Time

Date

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* 3. Additional Team Members
Full Name, Email, Date of Birth, Country, Organizational Affiliation

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* 4. Briefly describe your proposal to the Global Challenge
(300 words or less)

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* 5. If selected, will you be able to attend the MSMGF Pre-Meeting in Amsterdam, Netherlands on July 22nd, 2018?
All hotel costs and registration costs to attend AIDS 2018 for up to two people per team will be provided by MSMGF. Winning Innovation Teams will need to fund raise their transportation to Amsterdam.

Yes

Not sure

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* 6. Video Waiver
I hereby grant permission to MSMGF and its representatives to use and distribute any videos or recordings provided as part of my application to the Out With It Global Challenge. I hereby release MSMGF and its representatives from and against any claims, damages or liability arising from or related to the use of the images, recordings or materials, including but not limited to claims of defamation, invasion of privacy, or rights of publicity or copyright infringement. I am 18 years of age or older and I am competent to contract in my own name.

I have read this waiver and I fully understand the contents, meaning and impact of this consent, waiver, indemnity and release.

Please remember to film and submit your video application by March 15th, 2018

Videos should be uploaded to the following FTP: https://spaces.hightail.com/space/AbXrUUGm5u

If you have not already, please pre-register for Out With It pre-meeting here: https://www.eventbrite.com/e/out-with-it-the-msmgf-aids-2018-pre-meeting-and-reception-registration-42433631133

Please direct any questions regarding application to outwithit2018@gmail.com

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* 1. Primary Applicant

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* 2. Primary Applicant (Date of Birth)

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* 3. Additional Team MembersFull Name, Email, Date of Birth, Country, Organizational Affiliation

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* 4. Briefly describe your proposal to the Global Challenge(300 words or less)

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* 3. Additional Team Members
Full Name, Email, Date of Birth, Country, Organizational Affiliation

* 4. Briefly describe your proposal to the Global Challenge
(300 words or less)