Healing Our Movement Ecosystem (HOME) Jam 2017 Application

Note: We encourage you to cut-and-paste your answers to this application into a word doc, BEFORE you hit the submit button, as we are occasionally experiencing some technical difficulties with this contact form.  Once you have received confirmation from us that we received your application, then you can go ahead and delete the word doc. Thank you!

 

Important Note: Due to the small and personal nature of the event, this questionnaire is longer and more in-depth than most, because we want to get to know you better. Please share as much as you feel comfortable sharing. There is no min/max length for responses and no pressure. We only ask you to share what you feel is 'enough'. We will follow up with more questions or a phone call if we need more information.

Also, please note that all of your answers, including your name and basic info, will be kept in full confidentiality.* Only the leadership team will have access to your application. The more the team learns about you, the more informed their decision about selection can be.

Please note that we don't have a formal selection process. This is not a competition or a race where we select the best applications or judge whose work is better and whose isn't. However, we are limited to a maximum of 30 participants and we wish to ensure a circle of diversity with a right mix of qualities so that the potential of the space is enriched and it becomes meaningful for all. The selection would only reflect this attempt.

* Please note that if you are accepted, your name and bio will be shared with the other participants of your Jam just prior to the event. Following the Jam, we will put this information up on our website so that you can participate in the alumni community, unless you request otherwise. More info on this is below.

Complete Name (required)

Nickname (what you prefer to be called, if different):

Your Email (required)

Organization or Organizational Affiliation (if applicable):

Website of Group (if applicable):

Street Address (required)

City (required)

State / Province (required)

Zip / Postal Code (required)

Country (required)

Home Phone (if applicable):

Cell Phone (if applicable):

Work Phone (if applicable):

Birthday (Month/Day/Year) (required)

How did you hear about the Jam? Please list sources by name:

Who You Are

The people in the room are the focus of the Jam, and sharing our stories, experiences, ideas, etc., through different formats, is how we engage and learn together. The following series of questions is meant to be a taste of this principle. Don't worry about spelling or grammar or eloquent articulation. We just want to get a sense of who you feel you are.

How do you identify? (gender identity, ethnic background, sexual orientation, class, anything else that makes you who you are.) We ask because we value diversity, the opportunity to create safe space, and want to know how to best meet participant needs:

Tell us about yourself, what you are currently doing and how you came to be where you are. How do you feel connected to 'environmental work' (however you define it)?

What are you passionate about? What is your vision and hope for the present and the future?

What are some of the challenges you are currently facing in your life and work? What are your growing edges and questions?

What moves you to be part of the HOME Jam? What do you hope to give to the Jam? What do you hope to receive from the Jam?:

Please give us a mini-bio (a paragraph version of your story) written in the third person (for example, using "she" instead of "I"). Talk yourself up! Include contributions you've made, any awards or accomplishments, organizations you've been involved with, etc.

This is the bio that will be shared with other participants of this Jam, just prior to the Jam, and will be used for the YES! website. (You can always modify it later.) :

Optional: What other individuals or groups are you collaborating with (or would like to collaborate with) who might also be interested in attending this Jam? Please provide their full contact information if you would like for us to send them an invitation, or feel free to pass this invitation and application on to them.:

Costs of Attending

Tuition for the Jam is $1000, of which $550 covers food and lodging for the time, while $450 covers program expenses, including organizing support, childcare, materials, facilitator honorarium. A number of partial scholarships are available upon request, on an as-needed basis. Additional donations above the event price are welcome and help us to provide scholarships to enable the diversity upon which this event thrives (they are also tax-deductible). We never want money to be a barrier in participating in a Jam, so we will do everything we can to make it work for you to attend.

Are you or your organization in a position to pay the full tuition and/or the minimum request of $550 for tuition? If not, how much are you able to contribute (and what amount of scholarship would you require)?:

We invite work trades as well. Are there other non-monetary ways that you might be in reciprocity with the Jam (any particular skills, other in-kind contributions, etc.)?:

Travel expenses are the responsibility of the participant (the closest airports are San Francisco and Oakland, CA), though we do help to arrange carpools from the airport. We also have some partial travel scholarships. If you are selected for the Jam, we will be following up with you to ask you about diet, housing, travel plans, etc. We want to be sure to meet your needs at the Jam.

Thanks so much for taking the time to fill out this long application! We'll be in touch as soon as we can.

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Note: We encourage you to cut-and-paste your answers to this application into a word doc, BEFORE you hit the submit button, as we are occasionally experiencing some technical difficulties with this contact form.  Once you have received confirmation from us that we received your application, then you can go ahead and delete the word doc. Thank you!