CASH SPONSORSHIP APPLICATION First Name Last Name Email Address Phone Did you already speak with someone at any of the Kapor entities (LPFI, Kapor Center for Social Impact, Kapor Capital) regarding this sponsorship request or about your organization? If so, with whom did you speak? ORGANIZATION INFORMATION Organization Organization Address City StatePlease select... AL AK AZ AR CA CO CT DC DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Zip Code Website Legal StatusPlease select... 501(c)3 Nonprofit Fiscally Sponsored For-profit EIN Organization Mission FISCAL SPONSOR INFORMATION Fiscal Sponsor Organization First Name Last Name Email Address Phone Address City StatePlease select... AL AK AZ AR CA CO CT DC DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Zip Annual Budget amount EVENT INFORMATION Event Name Date of Event Event Location (City, State) Estimated Number of Attendees Description (include how funds will be used) Describe the event, estimated number of attendees, and how funds will be used. Also describe how your event will include and engage populations underrepresented in technology and how it will further tech equity and inclusion. Is this a free event? Yes No How much does it cost to participate in this event? Request Funding Amount Maximum request is $5000. Where can we find sponsorship levels and more information about the event? This sponsorship helps to:Build Tech SkillsIncrease Diverse EntrepreneurshipMobilize Tech for GoodOther Please Specify: DEMOGRAPHIC INFORMATION Please indicate if your organization fits any of the following categories (check all that apply) At least 50% of staff comprised of people of colorAt least 50% of Board comprised of people of colorExecutive Director or CEO is a person of colorThis grant request focuses on communities of colorNone of the above. *For our purposes, people of color are those who identify as African American/Black, Asian/Pacific Islander, Hispanic/Latino, Native American, or Mixed Heritage. (Check all that apply) Need assistance with this form?