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AMPLIFY HER LEADERSHIP NETWORK APPLICATION
2025 APPLICATION
Name
*
First Name
Last Name
Email
*
Phone
*
(###)
###
####
Are you over 18 years of age?
*
Yes
No
What borough(s) do you live or work in?
*
Bronx
Brooklyn
Manhattan
Queens
Staten Island
Organizational Affiliation
*
Title
*
(and/or self-employed, volunteer, etc.)
Please share a brief description of your past and current professional, educational and/or lived experience as it relates to the mission and vision of the Amplify Her Foundation? Please include any current organizational, board, advisory board, and/or other committee affiliations. Alternatively, you can email your resume or C.V. to info@amplifyherfoundation.org
*
LinkedIn Profile
Why are you interested in joining our Leadership Network?
*
It is important to the Amplify Her Foundation that our grantmaking process and by extension, the Leadership Network is diverse, inclusive, and reflective of the local community. How do you feel that your own lived experience and personal background will align and contribute to this goal?
*
Guidelines - Please review the guidelines below carefully.
*
I commit to making reasonable efforts to attend all meetings during my term.
I have no conflicts of interest that would prevent my participation in the Leadership Network.
I agree to sign a confidentiality agreement as part of my participation in the Leadership Network.
I have a potential conflict of interest that I would like to disclose below.
Potential Conflict of Interest
How did you learn about Amplify Her Foundation?
Word of Mouth
Social Media
Internet Search/ Website
Newsletter
Amplify Her
Other
Thank you for your interest in joining the Amplify Her Leadership Network! We will be in touch about next steps. If you have any questions in the meantime, please reach out to us at
info@amplifyherfoundation.org
.