Advocacy Learning Center Application

Before you complete this application please review the "Application Instruction Sheet" found on our HOW TO APPLY webpage of our website: (www.praxisinternational.org).

*We recommend that you copy and paste your responses on a word document in case there are any technical issues.*

Application Deadline: Submit your completed application by 5:00 PM Central time on Monday, March 19th, 2018.

Please Note: Your application will not be reviewed unless all application questions are complete and the required eligibility criterion is met. Applications will be considered based on the following criteria:

Your program is a community-based, tribal or campus advocacy organization providing direct services to women/survivors of violence against women, or a state, tribal, territory or national coalition/network that focuses on violence against women (If your program fails to meet this criterion, please consider partnering with your local community-based advocacy program).
Your program has the capacity to complete the 18-month course.
Your program and team members are committed to reflecting on and strengthening how you and your organization does advocacy.
Your proposed team includes a frontline advocate/crisis counselor and a manager/executive director.

If you have any questions please feel free to send an email to advoacy@praxisinternational.org.

Question Title

* 1. We are applying as a:

New applicant (our organization has never been involved in the ALC prior to this application).

Extended Placement Applicant (our organization was previously or currently* involved in the ALC.

*Only current programs that will have graduated by February 1, 2018, are eligible to apply for Class Q and R.

Previous ALC Class

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* 2. Which class are you applying to?

NOTE: You may apply to and be considered for Class Q OR Class R. If you would like to be considered for EITHER Class Q and R, check both boxes.

Class Q (Jun. 2018 - Nov. 2019)

Class R (Sep. 2018 - Feb. 2020)

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* 3. Main Contact Person (this is the person we will primarily be in contact with regarding your application, subsidy determinations, team composition decisions...).

Name:

Email:

Phone:

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* 4. Program Information

Program Name:

Street Address:

City:

State:

Zip Code:

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* 5. Briefly, tell us about your advocacy program (for example: your mission, number of years your organization has been providing advocacy services, and program size and structure).

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* 6. Do you consider your organization/program to be (check all that apply):

Primarily a domestic violence organization

Primarily a sexual assault organization

Primarily a dual domestic violence/sexual assault organization

Primarily a transitional housing program

Primarily a campus-based program

Primarily a program for victims of prostitution or trafficking

Primarily a program for immigrant victims

Primarily a program for victims of abuse in later life

Primarily a program for American Indian/Alaska Native victims

Other

Other (please specify)

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* 7. Is your primary purpose to provide advocacy in a culturally specific community or communities?

Yes

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* 8. If yes, which culturally specific communities do you work with?

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* 9. If no, are you in partnership with other organizations that are culturally specific?

Yes

If you are in partnership, please list those organizations

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* 1. We are applying as a:

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* 2. Which class are you applying to?NOTE: You may apply to and be considered for Class Q OR Class R. If you would like to be considered for EITHER Class Q and R, check both boxes.

Question Title

* 3. Main Contact Person (this is the person we will primarily be in contact with regarding your application, subsidy determinations, team composition decisions...).

Question Title

* 4. Program Information

Question Title

* 5. Briefly, tell us about your advocacy program (for example: your mission, number of years your organization has been providing advocacy services, and program size and structure).

Question Title

* 6. Do you consider your organization/program to be (check all that apply):

Question Title

* 7. Is your primary purpose to provide advocacy in a culturally specific community or communities?

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* 8. If yes, which culturally specific communities do you work with?

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* 9. If no, are you in partnership with other organizations that are culturally specific?

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* 10. List 3 specific reasons your organization/program would like to participate in the ALC course:

* 2. Which class are you applying to?

NOTE: You may apply to and be considered for Class Q OR Class R. If you would like to be considered for EITHER Class Q and R, check both boxes.