2018 Stage 1 Application

| Resume a previously saved form
Resume Later

In order to be able to resume this form later, please enter your email and choose a password.

Hidden Fields



Please Note

During the 2018 selection process, Epic will focus on identifying high-impact nonprofits and social enterprises that meet all of the following criteria:
  1. Demographic Focus: We are looking for organizations in which the primary focus is to support children and/or youth.
  2. Thematic Focus:  We are looking for high-impact nonprofits and social enterprises that work with children and youth within at least one of the following sectors:
    1. Education
    2. Economic Empowerment
    3. Rights & Protection
    4. Health (including Mental Health)
    5. Environment - This year we are including organizations in the environmental sector. We are particularly interested in organizations that work to empower children and/or youth for environmental outcomes (for ex. NGOs empowering, educating, targeting, mobilizing youth on environmental and climate change issues).
  3. Geographic Focus: We are looking for organizations within the following regions: Belgium, Cambodia, France, Germany, Mumbai (India), Kenya, New York or San Francisco/Bay Area (USA), Thailand, Uganda, United Kingdom and Vietnam. Please only apply if you are operating in one of these regions.

Please carefully review the criteria above before proceeding to complete an application, as we will not consider applications from organizations outside of these criteria.


Navigating the Application - You can return to this application to edit the information you have provided. Please use the "Next Page" or "Previous Page" buttons located at the bottom of the page to navigate this application. If you want to return to the previous page you must use the navigation buttons located at the bottom of each application page. Do not use your web browser navigation. 

Saving the Application - You can save your application at any time. Each time you save, you will be asked to enter an email and password. Please write this email and password down so you can come back to the application. Each time you save, you will be asked for an email and password. Use the same email and password as the first time you saved. 

Information - Epic Foundation will not share specific data on your organization to any third parties unless you provide authorization to do so. None of your specific responses to this application will be shared without explicit approval from your organization. 

For any questions, please first review our F.A.Q. and view this video. For further questions contact: Programs@Epic.Foundation
   


Registration
Tell Us About Your Organization


Please provide the location of your headquarters:







PLEASE NOTE: IF YOU ARE A NONPROFIT WITH BOTH NONPROFIT PROGRAMS AND SOCIAL ENTERPRISE OPERATIONS, PLEASE APPLY AS A NONPROFIT


Primary Geographic Service Area

This is the primary region where your organization operates


Format: (City/Province/State, Country; City/Province/State, Country...)
Chapter or Programs

Epic's Regions of Focus


How You Make An Impact

Please select a sector in order to access a more detailed list of sub-sectors










Tell Us About Your Beneficiaries




Tell Us About You





Do not use any spaces or symbols when inputting your number.

In case you are not available.

Your Impact

 

                         
Social Impact - Please define 1-3 key social outcomes you use to measure the long-term success of your organization. 




Social Impact - Please provide examples of key indicators or metrics for each of the social objectives you indicated in the "Social Impact" section above:






                   
Environmental Impact - Please define 1-3 key environmental outcomes you use to measure the long-term success of your organization.




Environmental Impact - Please provide examples of key indicators or metrics for each of the environmental objectives you indicated in the "Environmental Impact" section above:






 


Please title your file: "Organization Name - Annual Report"
 
Potential - Please rank to what extent each of the following factors are a barrier to your organization's ability to scale or enhance its impact. 
(1) Not A Barrier (2) Not A Barrier to Moderate Barrier (3) Moderate Barrier (4) Moderate Barrier to Extreme Barrier   (5) Extreme Barrier 
 


Program Innovation is innovation in the way you deliver your services and/or programs, communicate your message, or advocate for change.

Technology refers to any IT Systems and Mobile Software you use to manage your operations or programs.


Your Operations


Please title your file: "Organization Name - Financial Statement"
 

You can answer with short bullet points, no need to provide detailed explanations.
 


 


 






Your Team


We are referring to the number of board members for your specific organization, chapter, national office, etc, you are applying for.
 


Governance - Please upload or provide link to your organization's child protection policy.

Please label file as: "Organization Name - Child Protection Policy"


 
Expertise - We are interested to see evidence of your organization’s expertise. Please do not create any new documents for this section of the application; there is no single type of document or answer we are looking for.
An example of documents that could be attached include: Sector Research, Staff Training Guides/Curriculum, Resumes, Professional Development Strategy, etc. (2 Documents and/or Links Maximum)

Please title file as: "Organization Name - File Name"


Please title file as: "Organization Name - File Name"

 

Management - Please Upload/Provide Link to Biography, Resume or CV for at least one senior executive in your organization:

Please title your file: "Resume - Title "


Please title your file: "Resume - Title "

Partnerships - Using the table below, please rate the strength of the relationship your organization has with each of the types of partners from "None Existent" to a "Partnership Agreement/MOU": (Note: M.O.U = Memorandum of Understanding)
 
None Existent Infrequent Meetings/ Interaction Frequent Meetings/ Interaction  Partnership Agreement/M.O.U 
Your Impact


     
Social Impact - Please Define 1-3 key social outcomes you use to measure the long-term success of your organization. 



Social Impact - Please provide Example of Key Indicator or Metric for each of the social objectives you indicated in the "Impact" section above:






                        
Environmental Impact - Please define 1-3 key environmental outcomes you use to measure the long-term success of your organization.



Environmental Impact - Please provide examples of key indicators or metrics for each of the environmental objectives you indicated in the "Environmental Impact" section above:






 


Example: Business plan, pitch deck, investor presentations, etc. Please name file as: "Organization Name - Document Name"
 
Potential - Please rank to what extent each of the following factors are barriers to your organization's ability to scale or enhance its impact.
(1) Not A Barrier (2) Not A Barrier to Moderate Barrier (3) Moderate Barrier (4) Moderate Barrier to Extreme Barrier (5) Extreme Barrier
 


Program Innovation is innovation in the way you deliver your services and/or programs, communicate your message, or advocate for change.

Technology refers to any IT, Mobile, or Computer Systems you use operationally.



Please title your file: "Organization Name - Financial Statement"

Please title your file: "Organization Name - File Name"
 

Finance - We would like to know what types of investments you have received in the past. Please select yes if you have received any of the following types of investments. Just like all information submitted as part of this application the following details are strictly confidential and will not be shared.
Yes No
  
Finance - Please insert the amount received for each corresponding investment in USD: (Note: Input numbers only. No commas, or other symbols.)
$ Amount (USD)
Angel/Seed Investment (Optional)
Series A (Optional)
Series B (Optional)
Series C (Optional)
Other Equity Investment (Optional)
Debt (Optional)
Prizes/Competition Awards (Optional)
Grants (Optional)
Program Related Investment (PRIs) (Optional)
Forgivable Loan (Optional)
 
 
Efficiency - We are interested in understanding your approach to achieving efficiency. Using the data from your available Income Statements (P&L) for 2015 and 2016 please input your total revenue for each year. In addition, input your forecasted revenue for 2017.





 


 






Your Team


We are referring to the number of board members for your specific organization, chapter, national office, etc, you are applying for.




 
 
Expertise - We are interested to see evidence of your organization’s expertise. Please do not create any new documents for this section of the application; there is no single type of document or answer we are looking for.
An example of documents that could be attached include: Sector Research, Staff Training Guides/Curriculum, Resumes, Professional Development Strategy, etc. (2 Documents and/or Links Maximum)

Please title file as: "Organization Name - File Name"


Please title file as: "Organization Name - File Name"

                        
Management - Please Upload/Provide Link to Biography, Resume or CV for at least one senior executive in your organization:

Please title your file: "Resume - Title "


Please title your file: "Resume - Title "

 
Partnerships - Using the table below, please rate the strength of the relationship your organization has with each of the types of partners from 'None Existent" to a "Partnership Agreement/MOU":  (Note: M.O.U = Memorandum of Understanding) 
None Existent Infrequent Meetings/ Interaction Frequent Meetings/ Interaction  Partnership Agreement/M.O.U 
How Did You Hear About Epic Foundation?



Join Us In Creating An Open-Source Community

(This doesn't influence your application).

Comments

The following questions do not influence your application.