Creative Activist Program Membership Application
Please complete all required fields below before submitting!

Thank you for applying to the Creative Activist Program!

Our Creative Activist Program helps impact media makers develop and launch projects that use the power of story to raise awareness, drive change and awaken people to the potential of creating solutions to challenging local and global problems.

Through a Service Grants program model, industry professionals who volunteer their time and expertise to support the development, implementation, marketing, fundraising or distribution of film, music, performing and visual arts, or journalism projects and programs.

Applications are due on June 15th and decisions are sent out on July 15th.


PROJECT INFORMATION

a. WEBSITE:
b. FACEBOOK:
c. TWITTER:
d. YOUTUBE:
e. INSTAGRAM:
f. OTHER:

(We understand that sometimes projects may fall into more than one stage of development. Please select the option that best represents your current status.)

Development: Your project is still in the idea phase, developing a strategy, partnerships, and plan of action.
Production: Your project is in the creation phase, producing your media/art piece.
Distribution: Your media/art piece is completed, and you’re now sharing it with audiences.
Outreach: You’re engaging the media, partners and communities to take action.
Implementation: You’re implementing your action on the ground.

In 400 words or less, provide a project synopsis. What are you doing, and why? What gap are you filling, and why is this relevant at this point in time? Please describe desired reach and impact.

TEAM INFORMATION

1. FIRST NAME:
2. LAST NAME:
3. EMAIL:
4. City:
5. State:
6. Zip:
7. Bio(s) of key team members:

PROJECT DETAILS

  • Please carefully define a high level-goal and a measurable objective.
    • Ex: A high-level goal might be to pass a certain legislative bill.
    • Ex: A measurable objective might be to get 6 key legislators to vote for the legislation.
  • List 3 specific and realistic goals for the next 12 - 18 months.
Please attach any and all documents such as Articles of Incorporation, Bylaws, or any other organizational documents.

Please attach your working budget with either actual and/or projected costs over the next year.

Please list any advisors and/or board of directors