IMPACT HERO 2022 Application Form
Thank you for your interest in becoming our next Impact Hero!

Our Impact Heroes are visionary leaders that are driven by bottomless passion and resolute determination to make transformative changes to the communities they serve. They are not only role models for the next generations,  but also have the ability to inspire the world.

This is your opportunity to persuade us why you should be our next Impact Hero!

Full guidelines (including a list of eligible countries) are available for download here:
https://bit.ly/ImpactHero2022-guidelines

【Application Requirements】
Please submit the following:
1. Application Form (This Google form)
2. Video statement (up to 1 min in length) answering the following question:
      - Why should you be Earth Company's next Impact Hero?
    Tell us your story and convince us! This can be recorded on whatever device you have available to you.
    Please upload to Youtube / dropbox, etc, and share the link in this application form.
    ※ Videos longer than 1 min will not be considered.

If you have any questions, please email us at impact-hero@earthcompany.info   

Application page: https://www.earthcompany.info/impact-heroes/2022-applications/

Thank you, and we look forward to receiving your application!
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Email *
Impact Heroes possess the following qualities;
Eligibility
Earth Company is agnostic about number of years in operation, organizational maturity, sectoral focus, nationality, age, gender and academic credentials. For-profit companies and nonprofit organizations – and everything in between – are eligible.  While most successful candidates run organizations with annual budgets in the range of $100k-$1m, we welcome applications from smaller and larger organizations.

However, candidates must meet the following criteria.
Are you or your activities: *
Required
If you have checked all boxes above, please fill out the application form below.
Personal Info
Your Full Name *
Gender *
Age (Please enter number only) *
Nationality *
Current location *
About your activities
Name of your organization / initiative *
Your role in the organization? *
Website URL
Geographic focus of your activities *
Founding year of your organization / initiative *
Legal Status of your organization / initiative *
Required
Number of full-time employees *
Annual budget ($ USD) *
Either confirmed amount of previous fiscal year or an estimate of current fiscal year
Mission statement (*Word limit: 20 words) *
What does your organization do? How are you specifically solving the issues you are engaged in? (*Word limit: 50 words) *
What impact has your organization achieved? (*Word limit: 50 words) *
Tell us about yourself! WHY do you do what you do? Tell your story! This is one of the most important questions, so convince us ☺︎ (*Word limit: 100 words) *
Sustainable Development Goals (SDGs)
【No.1】Which Sustainable Development Goals (SDGs) are most relevant to your activities?  (*Choose up to 3 SDGs) *
【No.2】Which Sustainable Development Goals (SDGs) are most relevant to your activities? (if necessary)
【No.3】Which Sustainable Development Goals (SDGs) are most relevant to your activities? (if necessary)
Financial Status
Current financial model of your organization (*Word limit: 50 words) *
What are your main revenue streams (business income, grants, donations, etc.)? Please describe the top three sources of revenue including their amounts.
If you are selected as Impact Hero, how do you plan to use the $100,000 USD that Earth Company fundraises with and for you? (*Word limit: 100 words) *
Contact Info
Please enter the email address at which you'd like to receive important communications related to the selection process.  Please also make sure you are able to receive Google calendar invites from us at this email address.
Email (for confirmation, please enter the same address as at the beginning of this form) *
Your Video Statement
Please record a video answering the following question: Why should you be Earth Company's next Impact Hero? Tell us your story to convince us! (This can be recorded on whatever device you have available to you, e.g. your mobile phone. Please upload to Youtube / dropbox etc and give us the link here.) Longer videos will not be considered.
Video URL *
Last but not least...
How did you find out about Earth Company's Impact Hero award? *
Optional: Promotional materials (*Up to 3 materials)
If you'd like to send us your promotional materials (annual reports, brochures, video, etc.) for us to better understand your activities, please share the links to these materials or email them to impact-hero@earthcompany.info.
Thank you for filling out the application form!
A copy of your responses will be emailed to the address you provided.
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