Apply NOW for Breakthrough's Action Lab: March 23-25, 2018 at UNC - Chapel Hill!
Thank you for your interest in Breakthrough's Action Lab! By submitting this application, you are applying to be one of a diverse group of student leaders who will come together to challenge gender-based violence in your communities. The 2018 Action Lab will take place March 23-25, 2018 at the University of North Carolina-Chapel Hill.

This is your chance to use your expertise to challenge gender norms, harassment, assault, discrimination, and all forms of gender-based violence. Breakthrough will help you and your fellow students design iconic disruptive actions that we can take individually, in groups, and as a community. After the Action Lab, you'll continue to work with us at Breakthrough to implement your action and make change happen.

The 2018 application will close on February 5 at 12:00 PM ET. Students selected to attend will be notified by mid-February.

For more information about Breakthrough, please visit us.breakthrough.tv. For more photos and highlights from the 2017 Action Lab in New York City, please visit us.breakthrough.tv/action-lab.

Personal Information
First Name *
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Last Name *
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Address Line 1 *
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Address Line 2
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City *
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State *
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Zip Code *
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Email Address *
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Phone Number *
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Date of Birth *
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Campus Questions
College / University Currently Attending *
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Major / Area of Study *
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Graduation Date *
What extracurriculars are you involved in on your campus? *
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Personal Statements
Why do you want to be involved in Breakthrough's Action Lab? What do you have to contribute, and what do you hope to take away from this experience? *
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How do you think your community can benefit from your involvement in Breakthrough's Action Lab? What part(s) of your local culture do you wish to change? *
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Please share any experience you've had advocating for gender equality or other social justice issues. *
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Please share any experience you've had with leading, planning, and implementing projects, programs, and/or events on or off campus. (This does not have to be in the fields of social justice or gender equality). *
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Action Ideas
We'll spend our time together at the Action Lab designing, creating, and planning bold, hyperlocal projects. But we believe those actions are most impactful when they're driven by a leader with passion, commitment, and expertise. While we don't expect you to have a fully fleshed out action plan at this time, here's your space to tell us: What have you been thinking about lately? What is a specific problem related to gender-based violence and discrimination that's happening in your community for which you want to find a creative and disruptive solution? What do you think that solution would look like, and why are you the one to make it happen? Lastly, how long do you think it will take to build this campaign or action?
My idea is... *
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Demographic Information
Breakthrough strives to create programs that are as inclusive as possible, so we'd like to know a bit more about who you are. All questions in this section are OPTIONAL, and answers will not be shared with anyone.
Gender Identity
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Pronouns
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Race / Ethnicity
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Nationality
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Sexual Orientation
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Additional Information
Do you have the ability to attend the ENTIRE Action Lab, March 23-25 at the University of North Carolina-Chapel Hill? The program will take place from 4:00-6:00pm on the 23rd, and 9:00am-5:00pm on the 24th and 25th. *
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Are you applying with classmates from your campus? (Encouraged but not required). If so, please indicate their name(s). Note that all applicants must fill out separate applications.
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Breakthrough will be setting aside a small number of hotel rooms for people traveling from outside of North Carolina who do not have secured housing. Do you need to be considered for a hotel stay for the nights of March 23 and March 24? (Please note that you will be roomed with another Action Lab participant). *
How did you hear about this opportunity? *
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I'd like to be added to the Breakthrough email list to receive more information on trainings, updates, and other opportunities! *
Scholarship Funding
If you do not need to apply for scholarship funding, your application is now complete! Please skip this section and submit.

Breakthrough's Action Lab is free of charge to all participants. Breakfast, lunch, and snacks will be provided. While travel expenses are not covered for all, there are limited scholarship funds for those traveling greater distances or who may need assistance. Breakthrough is able to provide funding for local travel only; flights will not be reimbursed.

Scholarship funds will be on a sliding scale based on need. Students who receive scholarship funding will be notified along with their acceptance on January 26. Applying for scholarship funds does not guarantee funding; nor will it affect your chances of being accepted into the Action Lab.

Where are you traveling from? Please calculate your one-way travel time.
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I am asking for the following amount in travel funding:
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By signing my name here, I acknowledge that if granted travel funding, all funds will be distributed after the Action Lab, and I must save and submit receipts in order to receive funding. I also accept that I must attend and participate in the FULL Action Lab in order to receive travel reimbursement funds.
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