Elevate Giving Circle: Teachers & Educators Registration Form
Join us for this fast-paced
90-minute interactive session on
June 28 at 9:00-10:30am ET
and m
ake an outsized impact. Learn about and explore some of today’s most important social issues, meet like-minded people, and engage with experts working at the forefront of social change around the world.
(Please note that Elevate Giving circles will be held in English.)
Personal Information
First Name
Last Name
Email
Age
To which gender do you most identify?
Female
Male
Non-binary
Prefer to not answer
Please describe your race or ethnic group as you would define it.
Elevate Prize values radical diversity. The collection of this information is strictly for the internal purpose of ensuring that our programs continue to raise the baseline of diversity. This field is not required.
Country
Please select...
Afghanistan
Aland Islands
Albania
Algeria
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia, Plurinational State of
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Congo, the Democratic Republic of the
Cook Islands
Costa Rica
Cote d’Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands (Malvinas)
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See (Vatican City State)
Honduras
Hungary
Iceland
India
Indonesia
Iran, Islamic Republic of
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People’s Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People’s Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Macedonia, the former Yugoslav Republic of
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Moldova, Republic of
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Norway
Oman
Pakistan
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Qatar
Reunion
Romania
Russian Federation
Rwanda
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin (French part)
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten (Dutch part)
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Swaziland
Sweden
Switzerland
Syrian Arab Republic
Taiwan
Tajikistan
Tanzania, United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela, Bolivarian Republic of
Vietnam
Virgin Islands, British
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Malawi
State/Province
Please select...
None
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None
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None
Australian Capital Territory
New South Wales
Northern Territory
Queensland
South Australia
Tasmania
Victoria
Western Australia
None
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None
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None
Acre
Alagoas
Amapá
Amazonas
Bahia
Ceará
Distrito Federal
Espírito Santo
Goiás
Maranhão
Mato Grosso
Mato Grosso do Sul
Minas Gerais
Pará
Paraiba
Paraíba
Parana
Paraná
Pernambuco
Piaui
Piauí
Rio de Janeiro
Rio Grande do Norte
Rio Grande do Sul
Rondonia
Rondônia
Roraima
Santa Catarina
Sao Paulo
São Paulo
Sergipe
Tocantins
None
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None
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon Territories
None
None
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None
Anhui
Beijing
Chongqing
Fujian
Gansu
Guangdong
Guangxi
Guizhou
Hainan
Hebei
Heilongjiang
Henan
Hong Kong
Hubei
Hunan
Jiangsu
Jiangxi
Jilin
Liaoning
Macao
Nei Mongol
Ningxia
Qinghai
Shaanxi
Shandong
Shanghai
Sichuan
Taiwan
Tianjin
Xinjiang
Xizang
Yunnan
Zhejiang
Zhejiang
None
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None
Andaman and Nicobar Islands
Andhra Pradesh
Arunachal Pradesh
Assam
Bihar
Chandigarh
Chhattisgarh
Dadra and Nagar Haveli and Daman and Diu
Delhi
Goa
Gujarat
Haryana
Himachal Pradesh
Jammu and Kashmir
Jharkhand
Karnataka
Kerala
Ladakh
Lakshadweep
Madhya Pradesh
Maharashtra
Manipur
Meghalaya
Mizoram
Nagaland
Odisha
Puducherry
Punjab
Rajasthan
Sikkim
Tamil Nadu
Telangana
Tripura
Uttar Pradesh
Uttarakhand
West Bengal
None
None
None
Carlow
Cavan
Clare
Cork
Donegal
Dublin
Galway
Kerry
Kildare
Kilkenny
Laois
Leitrim
Limerick
Longford
Louth
Mayo
Meath
Monaghan
Offaly
Roscommon
Sligo
Tipperary
Waterford
Westmeath
Wexford
Wicklow
None
None
Agrigento
Alessandria
Ancona
Aosta
Arezzo
Ascoli Piceno
Asti
Avellino
Bari
Barletta-Andria-Trani
Belluno
Benevento
Bergamo
Biella
Bologna
Bolzano
Brescia
Brindisi
Cagliari
Caltanissetta
Campobasso
Carbonia-Iglesias
Caserta
Catania
Catanzaro
Chieti
Como
Cosenza
Cremona
Crotone
Cuneo
Enna
Fermo
Ferrara
Florence
Foggia
Forlì-Cesena
Frosinone
Genoa
Gorizia
Grosseto
Imperia
Isernia
L'Aquila
La Spezia
Latina
Lecce
Lecco
Livorno
Lodi
Lucca
Macerata
Mantua
Massa and Carrara
Matera
Medio Campidano
Messina
Milan
Modena
Monza and Brianza
Naples
Novara
Nuoro
Ogliastra
Olbia-Tempio
Oristano
Padua
Palermo
Parma
Pavia
Perugia
Pesaro and Urbino
Pescara
Piacenza
Pisa
Pistoia
Pordenone
Potenza
Prato
Ragusa
Ravenna
Reggio Calabria
Reggio Emilia
Rieti
Rimini
Rome
Rovigo
Salerno
Sassari
Savona
Siena
Sondrio
South Sardinia
South Tyrol
Syracuse
Taranto
Teramo
Terni
Trapani
Trento
Treviso
Trieste
Turin
Udine
Varese
Venice
Verbano-Cusio-Ossola
Vercelli
Verona
Vibo Valentia
Vicenza
Viterbo
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Southern Region
Northern Region
Central Region
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Aguascalientes
Baja California
Baja California Sur
Campeche
Chiapas
Chihuahua
Coahuila
Colima
Durango
Federal District
Guanajuato
Guerrero
Hidalgo
Jalisco
México
Michoacán
Morelos
Nayarit
Nuevo León
Oaxaca
Puebla
Querétaro
Quintana Roo
San Luis Potosí
Sinaloa
Sonora
Tabasco
Tamaulipas
Tlaxcala
Veracruz
Yucatán
Zacatecas
None
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Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
None
None
None
None
None
None
None
None
None
None
None
City
Are you a working professional or student?
Please select...
Professional
Student
Job Title
Organization
School/University
Tell us more about yourself.
Why do you want to participate in an Elevate Giving Circle? What is motivating you to join? What issues do you care about?
Please confirm you will be able to participate in this live 90 minute interactive session on
June 28 at 9:00-10:30am ET.
We will ask that you donate a personally significant amount, whether that’s $5, $50, $500 or more. Whatever you donate will be matched by Elevate Giving*, so your donation will have even more impact.
Yes! Can't wait to add to my calendar!
No, but I'm interested in learning more.
Have you been a part of a collective giving or giving circle experience before?
Please select...
Yes
No
How did you hear about Elevate Giving?
Social Media
Elevate Prize Foundation
Philanthropy Together
Trevor Noah Foundation
MIT Solve
Upworthy
Referral from someone else in my network
Other
Which social media platform did you learn about Elevate Giving?
Facebook
Instagram
LinkedIn
Twitter
YouTube
How else did you hear about Elevate Giving?
*Elevate Giving will match up to $75,000 in total donations across all giving circles in each cycle.
Contact Information