Supported by the Generosity of Angell Foundation

Thank you for your interest in the Platform Impact Leaders Fellowship! We look forward to learning more about you. We anticipate this application may take approximately 45 minutes to complete. Please schedule the time to complete this application in one sitting to ensure your information is not lost.  The application deadline is 5 p.m. on October 20, 2023. 

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* 1. Name:

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* 2. Personal Email address:

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* 3. Work Email address:

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* 4. Mailing address:

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* 5. Cell Phone number:

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* 6. What is the best way to reach you?:

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* 7. Name of your organization (if applicable):

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* 8. Title:

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* 9. Website:

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* 10. How did you hear about Platform Impact and why are you interested in the Platform Impact fellowship?

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* 11. Amidst the many needs facing our world today, what social problems or challenges do you feel are most important for you to address? Please explain why these are priority issues for you.

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* 12. How long have you served in a leadership position(s) in the nonprofit or social sectors? What led you to step into leadership?

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* 13. How do you identify as a person of color?

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* 14. What are your preferred personal pronouns?

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* 15. Have you experienced challenges and/or opportunities in leadership specifically as a person of color? If so, in what areas have you felt challenged? In what areas, if any, have you realized opportunities?

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* 16. What questions are you currently holding for your life? What if any timelines are associated with these questions?

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* 17. What, if anything, is requiring greater courage in your personal or professional life?

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* 18. When you think of your leadership platform, in what areas and with you whom do you have influence? In what ways, if any, have you leveraged this influence that you are especially proud of?

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* 19. Have you ever mentored an emerging (or more junior) leader? Are you open to serving as a mentor?

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* 20. What types of self-reflection practices do you currently use or have used in the past?

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* 21. How would you describe your self-care?

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* 22. Will you commit to attending all of the retreats in the series: In-person retreats Jan. 29 - Feb. 2, 2024, Apr. 22 - 26, 2024, Sep. 23 - 27 2024, Virtual retreat Dec. 6, 2024, Jan. 17, 2025?

Thank you for applying for the Platform Impact Leaders Fellowship. We will be in touch after the application review process is completed.

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