2020 SHIFT Summit Scholarship Application

Thank you for your interest in attending The 2020 SHIFT Summit. Please fill out this form to apply for a scholarship. In a continuing effort to make SHIFT an equitable and inclusive space, scholarships will be awarded based on a combination of merit, need, and representation. Scholarships cover all fees associated with the Summit and permit entry into all events.

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* 1. Your contact info:

First Name

Last Name

Job title

Organization/Institution

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number

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* 2. Gender Identification and Representation

Female

Male

Non-Binary

Prefer not to disclose/other

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* 3. I identify my Ethnicity as...

Asian

Black/African

Caucasian

Hispanic/Latinx

Native American

Pacific Islander

Prefer not to answer

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* 4. Why are you applying for a scholarship?

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* 5. What is the size of the organization for which you work?

Independent (just me)

2-7 team members

8-15 team members

16-25 team members

26-50 team members

51-100 team members

101+ team members

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* 6. How have you and/or your organization been impacted by Covid-19? (Check all that apply)

I have lost my position, been furloughed, or experienced reduced hours

Our organization has lost 25% or more of its funding

Our organization has reduced its workforce

Our organization has cut programming

I and/or my organization have been actively engaged in relief efforts related to Covid-19

Challenges associated with working from home and shelter-in-place orders have reduced my output / the output of my organization

2020 SHIFT Summit Scholarship Application

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* 1. Your contact info:

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* 2. Gender Identification and Representation

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* 3. I identify my Ethnicity as...

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* 4. Why are you applying for a scholarship?

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* 5. What is the size of the organization for which you work?

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* 6. How have you and/or your organization been impacted by Covid-19? (Check all that apply)

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* 7. What topics would you most like to learn about at The 2020 SHIFT Summit?

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* 8. What is your professional and/or personal interest in equitable access to nature and the mental health benefits of time outside?

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* 9. What perspectives or insights do you hope to bring to The 2020 SHIFT Summit?

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* 10. Please share any links about your work you would like us to consider in your evaluation here.