Tech For Change Eligibility Form

Full Name

First

Last

Job Title

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Email

Phone

Name of Organization

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Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Website / URL

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Annual Report or Strategic Plan

File Upload

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How many full-time employees does your organization have?

In which geographic regions does your organization operate, and how many clients do you serve in each of those regions?

Could you provide a brief description of the project or assessment your organization intends to pursue?

How does your agency anticipate benefiting from our Tech For Change Grant? (e.g. Sustainability, Operational Excellence, Capacity Building, etc.)

Has your agency secured full or partial funding to advance these initiatives?

What is the expected timeline for your current project? Please specify any critical dates.

What specific resources do you need from Process Fusion to successfully achieve your project goals?