Intake form

Name *

Email address *

What is your age group?

What is your current occupation?

Have you previously participated in any youth-led initiatives?

What type of support are you seeking?

Please select at least one option.

Financial Support

Leadership Development

Storytelling Assistance

Networking Opportunities

Please describe your initiative or project.

How did you learn about planet impact makers?

Please select at least one option.

Social Media

Word of Mouth

Website

Event

What are your main goals for this initiative?

Which areas of impact are you focusing on?

Please select at least one option.

Education

Health

Environment

Technology

Social Justice

Economic Development

Please provide any relevant links to your project or initiative.

What challenges are you currently facing with your initiative?

Which service or services are you interested in?

Please select at least one option.

Catalyzing access to Finance

Leadership development

Storytelling initiatives

Additional questions or comments

Planet Impact Makers