WIAL Better World Fund Application

Name *

First

Last

Email *

Your Organization *

Your Role *

What is the objective and mission of your organization? *

How many years has it been in operation? *

What is the organizational type? (charity, educational institution, other) *

Is the organization a registered non-profit? *

Yes
No

Who runs the organization? *

First

Last

Is it a local body or international affiliate? *

Local Body
International Affiliate

Who does the organization serve? *

How are the beneficiaries of the organization helped? *

Are you currently a recipient of any other funding? *

Yes
No
Not Sure

What are the current urgent needs of the organization? *

What type of Action Learning support are you looking for? *

How can WIAL or Action Learning coaching help you address your organization's needs? *

What is the estimated funding needed (if known) or preferred timing of the support required?

Is there any other information you would like to provide to support your application?

Personal Data *

Personal Data *

You acknowledge and agree that we may use your personal information consistent with our privacy policy and that we may share your information with the international WIAL organization and other WIAL Affiliates. Once you are certified as a coach or partner, you authorize us to post your contact information, and the photo, company name, title, website address, curriculum vitae or brochure, affiliation, credentials, bio and other similar information that you provide to us on WIAL directories and in other WIAL materials or communications, listing you as a coach or partner, as applicable.

WIAL Better World Fund Organizational Funding Application

To apply for a WIAL Better World grant, complete this form