Section 1: Background Information

Application Instructions: 
The selection process for the inaugural training is highly competitive. Please fill out all required fields on the application so we can learn more about your commitment, expertise, leadership, and how you will translate your Academy training into an actionable plan with measurable impact. You will need to click "Submit" at the end of the application (Section 6) to officially submit your application. Please note, if you do not click "Submit", your application will not be submitted. 

The deadline to apply is August 2, 2019. Decisions will be made by September 3, 2019. If you have any questions about the application process or the application itself, please contact Raven Gomez at rgomez@familiesusa.org.

For more information about the Health Equity Academy in System Transformation National Training, please visit https://familiesusa.org/initiatives/health-equity-academy-system-transformation

Application Format:
The application is comprised of six sections with a total of 22 questions, 9 of which are short answers (no more than 1-2 paragraphs). We encourage you to complete the application in one sitting to ensure your work is saved. You can view the application questions in advance here. We recommend answering the questions before you fill out the application, in order to ensure you fill out the application in one sitting. The application shouldn't take longer than 60 minutes to complete. 

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* 1. Name (First/Last)

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* 2. Email Address

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* 3. Phone Number

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* 4. Job Title

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* 5. Organization

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* 6. Organization Address
Please include street address, city, state, and zip code.

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