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return date; } </script> <link href="https://fonts.googleapis.com/css2?family=Didact+Gothic&display=swap" rel="stylesheet"> <style type="text/css"> h1,h2,h3 { font-family: 'Didact Gothic', sans-serif; } body { font-family: helvetica-w01-light,helvetica-w02-light,sans-serif; font-weight: 400; color: #1E557B; } p { font-family: helvetica-w01-light,helvetica-w02-light,sans-serif; font-weight: 400; color: #1E557B; } #tfa_2378-L, #tfa_2319-L, #tfa_2320-L, #tfa_2321-L, #tfa_2369-L, #tfa_2370-L, #tfa_2371-L { text-align: center; background-color: #7a9752; border: none; border-top: 4px solid #ffce2e; border-radius: 3px; margin: 0px 15px 0px 0px; height: initial; width: 75px; -webkit-font-smoothing: antialiased; padding: 25px 0px 25px 0px; font-family: inherit; font-size: 14px; font-weight: 600; color: #fff; cursor: pointer; } #tfa_2486-L, #tfa_2487-L, #tfa_2488-L, #tfa_2489-L, #tfa_2490-L, #tfa_2491-L, #tfa_2667-L { text-align: center; background-color: #7a9752; border: none; border-top: 4px solid #ffce2e; 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margin-top: 0px; margin-bottom: 25px; font-size: 24px; font-family: "open sans", Arial, Helvetica, sans-serif; vertical-align: top; color: rgb(74, 74, 74);">Impact Austin Impactship Application</h1><p style="line-height: 1.5em;"><font color="#000000"><span style="font-size: 13px;">Thank you for your interest in Impact Austin! We are delighted that you have chosen to join us in making a more significant impact through our collective giving efforts.</span></font></p><p style="line-height: 1.5em;"><font color="#000000"><span style="font-size: 13px;"><br></span></font></p><p style="line-height: 1.5em;"><font color="#000000"><span style="font-size: 13px;">Impact Austin is a women's collective giving organization based in Austin, Texas. We are dedicated to funding Central Texas nonprofits that provide essential services in Bastrop, Hays, Travis, and Williamson counties. Our organization is built on the belief that diversity of background and perspectives is crucial to understanding and addressing the complex issues facing Central Texas.</span></font></p><p style="line-height: 1.5em;"><font color="#000000"><span style="font-size: 13px;"><br></span></font></p><p style="line-height: 1.5em;"><font color="#000000"><span style="font-size: 13px;">At Impact Austin, we are committed to ensuring that financial constraints do not prevent women from participating in our giving circle. We invite you to complete this application to apply for an Impactship scholarship that covers a portion of the $1,250 Annual Membership Contribution for the upcoming year. </span></font></p><p style="line-height: 1.5em;"><font color="#000000"><span style="font-size: 13px;"><br></span></font></p><p style="line-height: 1.5em;"><font color="#000000"><span style="font-size: 13px;">Our goal is to promote a membership that truly represents the rich tapestry of our community. We understand that the cost of the full $1,250 annual membership contribution can be a barrier to participation and may limit our potential to be a genuinely inclusive organization.</span></font></p><p style="line-height: 1.5em;"><font color="#000000"><span style="font-size: 13px;"><br></span></font></p><p style="line-height: 1.5em;"><font color="#000000"><span style="font-size: 13px;"><b>The Impact Austin Impactship Program</b></span></font></p><p style="line-height: 1.5em;"><font color="#000000"><span style="font-size: 13px;"><br></span></font></p><p style="line-height: 1.5em;"><font color="#000000"><span style="font-size: 13px;">The Impactship program is designed to break down financial barriers to membership and enhance the diversity of our Impact Austin community. Our primary focus is to increase membership diversity through a selection and matching process firmly rooted in the trust-based model.</span></font></p><p style="line-height: 1.5em;"><font color="#000000"><span style="font-size: 13px;"><br></span></font></p><p style="line-height: 1.5em;"><font color="#000000"><span style="font-size: 13px;">Upon completing this application, you will be contacted within two weeks to inform you of the status of your request. We look forward to welcoming you as a valued member of Impact Austin.</span></font></p><p style="line-height: 1.5em;"><font color="#000000"><span style="font-size: 13px;"><br></span></font></p><p style="line-height: 1.5em;"><font color="#000000"><span style="font-size: 13px;">Thank you for your commitment to making an impact in our community and for taking the first step towards becoming an Impact Austin member through the Impactship program. Together, we can make a difference that reverberates throughout Central Texas.</span></font></p> </div></div> <div id="tfa_1" class="section group"> <label class="label preField" id="tfa_1-L"><h2 class="donation-subtitle" data-sc-ctx-bind="build.titleText()" style="margin-top: 0px; margin-bottom: 25px; box-sizing: inherit; font-size: 24px; color: rgb(74, 74, 74); font-family: "open sans", Arial, Helvetica, sans-serif;">Applicant Information</h2></label><br><div id="tfa_2353" class="section inline group"> <div class="oneField field-container-D " id="tfa_1868-D"> <label id="tfa_1868-L" class="label preField reqMark" for="tfa_1868">First Name </label><br><div class="inputWrapper"><input aria-required="true" type="text" id="tfa_1868" name="tfa_1868" value="" autocomplete="off" maxlength="40" title="First Name " class="calc-memberfname required"></div> </div> <div class="oneField field-container-D " id="tfa_1869-D"> <label id="tfa_1869-L" class="label preField reqMark" for="tfa_1869">Last 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<option value="tfa_2292" id="tfa_2292" class="">Work</option> <option value="tfa_2293" id="tfa_2293" class="">Other</option></select></div> </div> </div> <div id="tfa_2299" class="section inline group"> <div class="oneField field-container-D " id="tfa_1870-D"> <label id="tfa_1870-L" class="label preField reqMark" for="tfa_1870">Phone</label><br><div class="inputWrapper"><input aria-required="true" type="text" id="tfa_1870" name="tfa_1870" value="" autocomplete="off" placeholder="###-###-####" maskMaxLength="40" autoformat="###-###-####" title="Phone" class="validate-custom /^([$]{1}[0-9]{3}[$]{1}[\.| |\-]{0,1}|^[0-9]{3}[\.|\-| ]?)?[0-9]{3}(\.|\-| )?[0-9]{4}$/ required"></div> </div> <div class="oneField field-container-D " id="tfa_2295-D"> <label id="tfa_2295-L" class="label preField reqMark" for="tfa_2295">Phone Type</label><br><div class="inputWrapper"><select aria-required="true" id="tfa_2295" name="tfa_2295" title="Phone Type" class="required"><option value="">Please 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class="">California</option> <option value="tfa_2686" id="tfa_2686" class="">Colorado</option> <option value="tfa_2687" id="tfa_2687" class="">Connecticut</option> <option value="tfa_2688" id="tfa_2688" class="">Delaware</option> <option value="tfa_2689" id="tfa_2689" class="">District Of Columbia</option> <option value="tfa_2690" id="tfa_2690" class="">Florida</option> <option value="tfa_2691" id="tfa_2691" class="">Georgia</option> <option value="tfa_2692" id="tfa_2692" class="">Hawaii</option> <option value="tfa_2693" id="tfa_2693" class="">Idaho</option> <option value="tfa_2694" id="tfa_2694" class="">Illinois</option> <option value="tfa_2695" id="tfa_2695" class="">Indiana</option> <option value="tfa_2696" id="tfa_2696" class="">Iowa</option> <option value="tfa_2697" id="tfa_2697" class="">Kansas</option> <option value="tfa_2698" id="tfa_2698" class="">Kentucky</option> <option value="tfa_2699" id="tfa_2699" class="">Louisiana</option> <option value="tfa_2700" id="tfa_2700" class="">Maine</option> <option value="tfa_2701" id="tfa_2701" class="">Maryland</option> <option value="tfa_2702" id="tfa_2702" class="">Massachusetts</option> <option value="tfa_2703" id="tfa_2703" class="">Michigan</option> <option value="tfa_2704" id="tfa_2704" class="">Minnesota</option> <option value="tfa_2705" id="tfa_2705" class="">Mississippi</option> <option value="tfa_2706" id="tfa_2706" class="">Missouri</option> <option value="tfa_2707" id="tfa_2707" class="">Montana</option> <option value="tfa_2708" id="tfa_2708" class="">Nebraska</option> <option value="tfa_2709" id="tfa_2709" class="">Nevada</option> <option value="tfa_2710" id="tfa_2710" class="">New Hampshire</option> <option value="tfa_2711" id="tfa_2711" class="">New Jersey</option> <option value="tfa_2712" id="tfa_2712" class="">New Mexico</option> <option value="tfa_2713" id="tfa_2713" class="">New York</option> <option value="tfa_2714" id="tfa_2714" class="">North Carolina</option> <option value="tfa_2715" id="tfa_2715" class="">North Dakota</option> <option value="tfa_2716" id="tfa_2716" class="">Ohio</option> <option value="tfa_2717" id="tfa_2717" class="">Oklahoma</option> <option value="tfa_2718" id="tfa_2718" class="">Oregon</option> <option value="tfa_2719" id="tfa_2719" class="">Pennsylvania</option> <option value="tfa_2720" id="tfa_2720" class="">Rhode Island</option> <option value="tfa_2721" id="tfa_2721" class="">South Carolina</option> <option value="tfa_2722" id="tfa_2722" class="">South Dakota</option> <option value="tfa_2723" id="tfa_2723" class="">Tennessee</option> <option value="tfa_2724" id="tfa_2724" class="" selected data-default-value="true">Texas</option> <option value="tfa_2725" id="tfa_2725" class="">Utah</option> <option value="tfa_2726" id="tfa_2726" class="">Vermont</option> <option value="tfa_2727" id="tfa_2727" class="">Virginia</option> <option value="tfa_2728" id="tfa_2728" class="">Washington</option> <option value="tfa_2729" id="tfa_2729" class="">West Virginia</option> <option value="tfa_2730" id="tfa_2730" class="">Wisconsin</option> <option value="tfa_2731" id="tfa_2731" class="">Wyoming</option> <option value="tfa_2732" id="tfa_2732" class="">Puerto Rico</option> <option value="tfa_2733" id="tfa_2733" class="">Virgin Island</option> <option value="tfa_2734" id="tfa_2734" class="">Northern Mariana Islands</option> <option value="tfa_2735" id="tfa_2735" class="">Guam</option> <option value="tfa_2736" id="tfa_2736" class="">American Samoa</option> <option value="tfa_2737" id="tfa_2737" class="">Palau</option></select></div> </div> <div class="oneField field-container-D " id="tfa_2738-D"> <label id="tfa_2738-L" class="label preField reqMark" for="tfa_2738">Postal Code</label><br><div class="inputWrapper"><input aria-required="true" type="text" id="tfa_2738" name="tfa_2738" value="" title="Postal Code" class="validate-integer required"></div> </div> <div class="oneField field-container-D " id="tfa_2749-D"> <label id="tfa_2749-L" class="label preField reqMark" for="tfa_2749">County</label><br><div class="inputWrapper"><input aria-required="true" type="text" id="tfa_2749" name="tfa_2749" value="" title="County" class="required"></div> </div> </div> </div> </div> <div id="tfa_2628" class="section group"> <label class="label preField" id="tfa_2628-L"><h2 style="box-sizing: inherit; margin-top: 0px; margin-bottom: 25px; font-size: 24px; font-family: "open sans", Arial, Helvetica, sans-serif; color: rgb(74, 74, 74);" class="donation-subtitle" data-sc-ctx-bind="build.titleText()">Additional Information</h2></label><br><div id="tfa_2650" class="section group"> <div class="oneField field-container-D " id="tfa_2745-D"> <label id="tfa_2745-L" class="label preField reqMark" for="tfa_2745">How did you learn about Impact Austin? About the Impactship?</label><br><div class="inputWrapper"><textarea aria-required="true" data-maxwords="1250" id="tfa_2745" name="tfa_2745" title="How did you learn about Impact Austin? About the Impactship?" class="required count-words"></textarea></div> </div> <div class="oneField field-container-D " id="tfa_2747-D"> <label id="tfa_2747-L" class="label preField reqMark" for="tfa_2747"><span style="font-size: 14.4px;">What excites you about being an Impact Austin member?</span></label><br><div class="inputWrapper"><textarea aria-required="true" data-maxwords="1250" id="tfa_2747" name="tfa_2747" title="What excites you about being an Impact Austin member?" class="required count-words"></textarea></div> </div> <div class="oneField field-container-D " id="tfa_2751-D"> <label id="tfa_2751-L" class="label preField reqMark" for="tfa_2751"><span style="font-size: 14.4px;">What are you passionate about in our community?</span></label><br><div class="inputWrapper"><textarea aria-required="true" data-maxwords="1250" id="tfa_2751" name="tfa_2751" title="What are you passionate about in our community?" class="required count-words"></textarea></div> </div> <div class="oneField field-container-D " id="tfa_2753-D"> <label id="tfa_2753-L" class="label preField reqMark" for="tfa_2753"><span style="font-size: 14.4px;">What are you hoping to learn in Impact Austin?</span></label><br><div class="inputWrapper"><textarea aria-required="true" data-maxwords="1250" id="tfa_2753" name="tfa_2753" title="What are you hoping to learn in Impact Austin?" class="required count-words"></textarea></div> </div> </div> <div class="htmlSection" id="tfa_2755"><div class="htmlContent" id="tfa_2755-HTML"><span style="font-size: 14.4px;">Impact Austin membership dues are $1,250 per year or $108/month for 12 installments. How much are you able to contribute to the membership fee? Enter payment amount and frequency below. Note that you can request up to the full membership fee amount ($1,250).</span></div></div> <div id="tfa_2581" class="section group"><div id="tfa_2760" class="section inline group"> <div class="oneField field-container-D " id="tfa_2582-D"> <label id="tfa_2582-L" class="label preField " for="tfa_2582">I can contribute this amount monthly.</label><br><div class="inputWrapper"><input type="text" id="tfa_2582" name="tfa_2582" value="" title="I can contribute this amount monthly." class="calc-school"></div> </div> <div class="oneField field-container-D " id="tfa_2759-D"> <label id="tfa_2759-L" class="label preField " for="tfa_2759">I can contribute this amount as a one-time annual gift.</label><br><div class="inputWrapper"><input type="text" id="tfa_2759" name="tfa_2759" value="" title="I can contribute this amount as a one-time annual gift." class="calc-school"></div> </div> </div></div> <div id="tfa_2616" class="section group"> <label class="label preField" id="tfa_2616-L"><b>Diversity Statement:</b></label><br><div class="htmlSection" id="tfa_2757"><div class="htmlContent" id="tfa_2757-HTML"><span style="font-size: 13px;"> Impact Austin's Diversity, Equity and Inclusion (DEI) efforts are designed to help us better represent the communities in which we operate. Any information you provide will be handled confidentially, and used in aggregate to track our progress toward our DEI goals. Please check the appropriate racial/ ethnic category: </span></div></div> <div id="tfa_2618" class="section inline group"> <div class="oneField field-container-D " id="tfa_2619-D"> <label id="tfa_2619-L" class="label preField reqMark" for="tfa_2619">Select Racial / Ethnic Identity</label><br><div class="inputWrapper"><select aria-required="true" id="tfa_2619" name="tfa_2619" title="Select Racial / Ethnic Identity" class="required"><option value="">Please select...</option> <option value="tfa_2620" id="tfa_2620" class="">American Indian / Alaska Native</option> <option value="tfa_2621" id="tfa_2621" class="">Asian</option> <option value="tfa_2622" id="tfa_2622" class="">Black / African American</option> <option value="tfa_2623" id="tfa_2623" class="">White</option> <option value="tfa_2624" id="tfa_2624" class="">Hispanic</option> <option value="tfa_2625" id="tfa_2625" class="">Native Hawaiian / Pacific Islander</option> <option value="tfa_2626" id="tfa_2626" class="">I choose not to say</option></select></div> </div> <div class="oneField field-container-D labelsAbove hintsTooltip " id="tfa_2627-D"> <label id="tfa_2627-L" class="label preField " for="tfa_2627">Birth Year</label><br><div class="inputWrapper"> <input type="text" id="tfa_2627" name="tfa_2627" value="" autocomplete="off" maxlength="4" aria-describedby="tfa_2627-HH" min="1900" max="2999" title="Birth Year" class="validate-integer"><span class="field-hint-inactive" id="tfa_2627-H"><span id="tfa_2627-HH" class="hint">Please enter a 4 digit numerical year (e.g. 1968)</span><button id="tfa_2627-HH-close-button" class="field-hint-close-button" type="button" tabindex="-1" aria-hidden="true" aria-label="Close"> x </button></span> </div> </div> </div> </div> <div id="tfa_2773" class="section group"> <label class="label preField" id="tfa_2773-L"><b>Availability Statement:</b></label><br><div class="htmlSection" id="tfa_2774"><div class="htmlContent" id="tfa_2774-HTML">Funds are limited, and this application may be considered now or in the future when funds are available. </div></div> </div> </div> <div class="actions" id="5091072-A" data-contentid="submit_button"><input type="submit" data-label="Submit" class="primaryAction" id="submit_button" value="Submit"></div> <div style="clear:both"></div> <input type="hidden" value="333-3c8ad0b4d98e7a2cfb05def6a0aecee4" name="tfa_dbCounters" id="tfa_dbCounters" autocomplete="off"><input type="hidden" value="5091072" name="tfa_dbFormId" id="tfa_dbFormId"><input type="hidden" value="" name="tfa_dbResponseId" id="tfa_dbResponseId"><input type="hidden" value="61f501ad2bdf5ac1abd350585eaa0716" name="tfa_dbControl" id="tfa_dbControl"><input type="hidden" value="" name="tfa_dbWorkflowSessionUuid" id="tfa_dbWorkflowSessionUuid"><input type="hidden" value="1744051232" name="tfa_dbTimeStarted" id="tfa_dbTimeStarted" autocomplete="off"><input type="hidden" value="4" name="tfa_dbVersionId" id="tfa_dbVersionId"><input type="hidden" value="" name="tfa_switchedoff" id="tfa_switchedoff"> </form> </div></div><div class="wFormFooter"><p class="supportInfo"><br></p></div> <p class="supportInfo" > </p> </div> </div> <script src='https://www.tfaforms.com/js/iframe_message_helper_internal.js?v=2'></script> </body> </html>

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