Unity + Inclusion Summit Miami - Diversity Scholarship Application

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Want a complimentary ticket to the Unity & Inclusion Summit in Miami?

We'll be randomly selecting individuals to receive 1 ticket based on the below survey.

We will award these in 2 rounds:
1st round: Selected individuals will be notified around Wednesday, Feb 20.
2nd round: Selected individuals will be notified around Friday, March 1.

Please DO NOT fill this out if you are financially able to afford a ticket.
In an effort to be inclusive, we want to award these tickets to those who would be unable to attend otherwise.

Thank you, and we hope to see you at U+I Miami on Thursday, March 7!

Tickets: unityandinclusionmiami.eventbrite.com

More info about 500 Startups: 500.co

NOTE: Scholarship includes ticket price only. Lodging and transportation are not included.

Name *

Company *

Job Title *

Email *

Please tell us why you should receive a scholarship. What do you hope to get out of this event? *

I am....

Female

Male

Nonbinary/Third Gender

LGBTQIA+

Veteran / Active Military

Person with a disability (visible or invisible)

Black or African American

White, Anglo or European-American

Hispanic or Latino

Native Hawaiian or Pacific Islander

Indigenous or Native American

East Asian

South Asian or Southeast Asian

Middle Eastern, North African or Arab-American

Other:

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of 500 Global. Report Abuse

Forms