Referring Nonprofits to Epic's Selection Process

Referring Nonprofits to Epic's Selection Process

We appreciate the time you are taking to refer nonprofits to Epic's portfolio. Please use the form below to provide basic information for your referral. You can repeat this form as many times as you wish for each nonprofit you want to refer.

Data Privacy: All information provided in this form will be kept confidential and will not be shared with other third-parties.

Name:

Organization:

The nonprofit I would like to nominate is:

Website of the nonprofit:

The nominee implements programs in the following countries(choose all that apply):

Belgium	Cambodia	France
India	Kenya	Uganda
United Kingdom	United States	Vietnam
None of the above

The nominee impacts the following sectors (choose all that apply):

Children and youth

Environment and climate

Nominee Contact Information:

First Name

Last Name

Position/Title

Email

Contact Information