To be considered for participation in the Project Impact cohort starting in October 2018, please submit the following application.  We will be in touch to talk with you about participating in Project Impact within a few days of receiving your application.  Thank you! 

Primary Contact Name *
Primary Contact Name
Preferred Phone *
Preferred Phone
Organization's Address
Organization's Address
Please note that teams will be comprised of 2-5 people (talk to us if you want more). At least one person on each team should be in a position to influence organizational direction. Teams should also include at least one person with frontline expertise. Board members are also encouraged to participate. ED participation is not required but is encouraged.