Micah Fellows Program - Cohort 3 Application

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* 1. Your Legal Name

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* 2. Your Pronouns

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* 3. Please provide your most frequently checked email.

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* 4. Please provide your phone number.

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* 5. In what county do you reside?

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* 6. Address

Street

Street Line 2

City/Town

State/Region/Province

Zip/Post Code

Country

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* 7. We'd like to collect some information about your context

Affiliated Organization(s) - please separate with commas

Title

Years of experience in your role

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* 8. Reference One
Please provide name and contact information for two references who can speak to who you are, your skills, and your leadership.

First Name

Last Name

Phone Number

Company/Organization

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* 9. Reference Two
Please provide name and contact information for two references who can speak to who you are, your skills, and your leadership.

First Name

Last Name

Phone Number

Company/Organization

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* 10. Micah Fellows Learning Journey Commitments & Events
We ask that you submit your application only if you can agree to hold the following dates available on your calendar for the learning journey.

Virtual Information Session - Dec 16, 2024, 12pm - 1pm CT
Virtual Micah Fellows Cohort Orientation - Jan 15, 2025, 12pm CT
In-Person Retreat - Feb 19, 2025, 6pm - 8pm, Feb 20, 2025, 9am - 4pm CT
In-Person Legislative Day - March 19, 2025, 9am - 1pm
Virtual Core Teachings - March 6, 2025, April 9, 2025, May 7, 2025,
Each Core Teaching will be held 1pm - 2pm CT.
Mini Grant Information Session - June 4, 2025, 12:00pm - 1:00pm, CT
Spiritual Formation Calls - Beginning in Feb 2025 ending in Aug 2025
Mini Grants - June - August 2025
Debrief/Evaluation Session - Nov 6, 2025, 2pm, CT

If you agree to hold these dates, please enter your first and last name to signify your agreement.

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* 11. How did you hear about the Micah Fellows Program?

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* 12. Tell us about your work and how you show up as a leader in your community.

Please keep your answer to a maximum of 250 words.

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* 13. How do you envision the connection between anti-poverty work and healing in your work /ministry with your community?

Please keep your answer to a maximum of 250 words.

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* 14. Are there anti-poverty policy issues that you plan address to OR are actively addressing as part of your ministry work?

Please keep your answer to a maximum of 250 words.

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* 15. Are you familiar with ALICE (Asset Limited, Income Constrained, and Employed) Arkansans? Please share your understanding or knowledge about ALICE.

Please keep your answer to a maximum of 250 words.

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* 16. How are you hoping to grow in your role as a moral leader in addressing anti-poverty work in Arkansas ?

Please keep your answer to a maximum of 250 words.

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* 17. How would you describe your level of knowledge of and experience with public policy advocacy?

Beginner

Intermediate

Advanced

Expert

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* 18. Which of the following best describes your primary motivation for applying to Micah Fellows Learning Journey?

To advance my current work

To gain experience

To develop a new skill or expertise

To contribute to the community or society

To be equipped as a spiritual leader

Other

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* 19. Which of the following best describes your primary motivation for applying to Micah Fellows Learning Journey?

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* 20. Which of the following best describes your primary motivation for applying to Micah Fellows Learning Journey?
Please keep your answer to a maximum of 250 words.

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* 21. Do you currently utilize social media? If the answer is yes, which platforms do you currently use, and what are your handles? Please list them below. Ex. Instagram - @micahfellowsar

If you do not utilize social media platforms, are you interested in learning more information about them? Please be specific?

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* 22. We are aware that Arkansas has broadband deserts in certain areas. Do you have a computer with a webcam and built-in mic, internet connection, and a quiet space to call into monthly video calls?

Yes

Maybe

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* 23. Now that you know more about this opportunity, why do you believe that you (and your community) would benefit from this learning journey experience?

Please keep your answer to a maximum of 250 words.

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* 24. What is your age group?

While this response is not required, we strongly encourage you to complete them because we would like to collect some demographic data to ensure that we achieve equitable representation across our programs.

18 - 30

31 - 40

41 - 50

51 - 60

61 and better

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* 25. What is your gender?

While this response is not required, we strongly encourage you to complete them because we would like to collect some demographic data to ensure that we achieve equitable representation across our programs.

Agender

Man

Nonbinary/Genderqueer

Transgender

Woman

Other

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* 26. What is your sexuality?

While this response is not required, we strongly encourage you to complete them because we would like to collect some demographic data to ensure that we achieve equitable representation across our programs.

Ace/Aro

Gay

Lesbian

Pansexual

Queer

Straight

Other

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* 27. How do you racially identify?

While this response is not required, we strongly encourage you to complete them because we would like to collect some demographic data to ensure that we achieve equitable representation across our programs.

American Indian or Alaska Native

Black/African

Caribbean/Latin American Native

Eastern Asian

Hispanic or Latin

Native Hawaiian or Pacific Islander

South Asian

Western Asian

White

Other

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* 28. How do you ethnically identify?

While this response is not required, we strongly encourage you to complete them because we would like to collect some demographic data to ensure that we achieve equitable representation across our programs.

Hispanic or Latino

Not Hispanic or Latino

Other

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* 29. How would you describe your economic class?

While this response is not required, we strongly encourage you to complete them because we would like to collect some demographic data to ensure that we achieve equitable representation across our programs.

Low-Income

Working-Class

Middle Class

Owning class or wealthy

Other

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* 30. What is your highest level of education?

While this response is not required, we strongly encourage you to complete them because we would like to collect some demographic data to ensure that we achieve equitable representation across our programs.

some high school

high school diploma

Associate's Degree

Bachelor's Degree

Master's Degree

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* 31. How would you describe your current spiritual or religious identity/affinity? Please select all that apply.

While this response is not required, we strongly encourage you to complete them because we would like to collect some demographic data to ensure that we achieve equitable representation across our programs.

Agnostic

Atheist

African Traditional Religion

African Diasporic Religion

Baha'i

Buddhist

Christian

Eastern Folk Religion

Hindu

Muslim

North/Central/South American Indigenous Religions

Pagan/Wicca/European Esoteric Tradition

Quaker

Spiritual (non-religious)

Unitarian Universalist

Other

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* 32. Are you strongly affiliated with a Christian denominational identity? If so, please list it below.

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* 33. If there are any demographic multiple choice questions that did not capture nuances of your identity that you wish to share, please note that here.

Micah Fellows Program - Cohort 3 Application

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* 1. Your Legal Name

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* 2. Your Pronouns

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* 3. Please provide your most frequently checked email.

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* 4. Please provide your phone number.

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* 5. In what county do you reside?

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* 6. Address

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* 7. We'd like to collect some information about your context

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* 8. Reference OnePlease provide name and contact information for two references who can speak to who you are, your skills, and your leadership.

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* 9. Reference TwoPlease provide name and contact information for two references who can speak to who you are, your skills, and your leadership.

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* 11. How did you hear about the Micah Fellows Program?

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* 12. Tell us about your work and how you show up as a leader in your community.Please keep your answer to a maximum of 250 words.

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* 13. How do you envision the connection between anti-poverty work and healing in your work /ministry with your community?Please keep your answer to a maximum of 250 words.

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* 14. Are there anti-poverty policy issues that you plan address to OR are actively addressing as part of your ministry work?Please keep your answer to a maximum of 250 words.

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* 15. Are you familiar with ALICE (Asset Limited, Income Constrained, and Employed) Arkansans? Please share your understanding or knowledge about ALICE.Please keep your answer to a maximum of 250 words.

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* 16. How are you hoping to grow in your role as a moral leader in addressing anti-poverty work in Arkansas ?Please keep your answer to a maximum of 250 words.

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* 17. How would you describe your level of knowledge of and experience with public policy advocacy?

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* 18. Which of the following best describes your primary motivation for applying to Micah Fellows Learning Journey?

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* 19. Which of the following best describes your primary motivation for applying to Micah Fellows Learning Journey?

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* 20. Which of the following best describes your primary motivation for applying to Micah Fellows Learning Journey?Please keep your answer to a maximum of 250 words.

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* 22. We are aware that Arkansas has broadband deserts in certain areas. Do you have a computer with a webcam and built-in mic, internet connection, and a quiet space to call into monthly video calls?

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* 23. Now that you know more about this opportunity, why do you believe that you (and your community) would benefit from this learning journey experience?Please keep your answer to a maximum of 250 words.

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* 24. What is your age group?While this response is not required, we strongly encourage you to complete them because we would like to collect some demographic data to ensure that we achieve equitable representation across our programs.

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* 25. What is your gender?While this response is not required, we strongly encourage you to complete them because we would like to collect some demographic data to ensure that we achieve equitable representation across our programs.

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* 26. What is your sexuality?While this response is not required, we strongly encourage you to complete them because we would like to collect some demographic data to ensure that we achieve equitable representation across our programs.

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* 27. How do you racially identify?While this response is not required, we strongly encourage you to complete them because we would like to collect some demographic data to ensure that we achieve equitable representation across our programs.

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* 28. How do you ethnically identify?While this response is not required, we strongly encourage you to complete them because we would like to collect some demographic data to ensure that we achieve equitable representation across our programs.

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* 29. How would you describe your economic class?While this response is not required, we strongly encourage you to complete them because we would like to collect some demographic data to ensure that we achieve equitable representation across our programs.

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* 30. What is your highest level of education?While this response is not required, we strongly encourage you to complete them because we would like to collect some demographic data to ensure that we achieve equitable representation across our programs.

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* 32. Are you strongly affiliated with a Christian denominational identity? If so, please list it below.

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* 33. If there are any demographic multiple choice questions that did not capture nuances of your identity that you wish to share, please note that here.

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* 34. Thank you so much for taking this time to introduce yourself and your work to us. Do you have any additional questions or comments for us?

* 8. Reference One
Please provide name and contact information for two references who can speak to who you are, your skills, and your leadership.

* 9. Reference Two
Please provide name and contact information for two references who can speak to who you are, your skills, and your leadership.

* 12. Tell us about your work and how you show up as a leader in your community.

Please keep your answer to a maximum of 250 words.

* 13. How do you envision the connection between anti-poverty work and healing in your work /ministry with your community?

Please keep your answer to a maximum of 250 words.

* 14. Are there anti-poverty policy issues that you plan address to OR are actively addressing as part of your ministry work?

Please keep your answer to a maximum of 250 words.

* 15. Are you familiar with ALICE (Asset Limited, Income Constrained, and Employed) Arkansans? Please share your understanding or knowledge about ALICE.

Please keep your answer to a maximum of 250 words.

* 16. How are you hoping to grow in your role as a moral leader in addressing anti-poverty work in Arkansas ?

Please keep your answer to a maximum of 250 words.

* 20. Which of the following best describes your primary motivation for applying to Micah Fellows Learning Journey?
Please keep your answer to a maximum of 250 words.

* 23. Now that you know more about this opportunity, why do you believe that you (and your community) would benefit from this learning journey experience?

Please keep your answer to a maximum of 250 words.

* 24. What is your age group?

While this response is not required, we strongly encourage you to complete them because we would like to collect some demographic data to ensure that we achieve equitable representation across our programs.

* 25. What is your gender?

While this response is not required, we strongly encourage you to complete them because we would like to collect some demographic data to ensure that we achieve equitable representation across our programs.

* 26. What is your sexuality?

While this response is not required, we strongly encourage you to complete them because we would like to collect some demographic data to ensure that we achieve equitable representation across our programs.

* 27. How do you racially identify?

While this response is not required, we strongly encourage you to complete them because we would like to collect some demographic data to ensure that we achieve equitable representation across our programs.

* 28. How do you ethnically identify?

While this response is not required, we strongly encourage you to complete them because we would like to collect some demographic data to ensure that we achieve equitable representation across our programs.

* 29. How would you describe your economic class?

While this response is not required, we strongly encourage you to complete them because we would like to collect some demographic data to ensure that we achieve equitable representation across our programs.

* 30. What is your highest level of education?

While this response is not required, we strongly encourage you to complete them because we would like to collect some demographic data to ensure that we achieve equitable representation across our programs.