Apply Now to Make a Lasting Impact in the World APPLY Apply now and book your interview INTERVIEW If your interview is successful confirm place with deposit PACK YOUR BAGS Enterprise match and you’re ready to go! ChangeU Application ChangeU Application Step 1 of 3 0% Thank you for your interest in working for a ChangeU social enterprise partner. Please complete each field of the application, marking “NA” if the field does not apply to you. Thank you for your interest in a Change University volunteer. ChangeU will use the information you provide both to evaluate the appropriateness of your company/organization to become a ChangeU Partner and to match your organization with qualified volunteers that meet your expressed criteria. Please fill out the Profile Form completely and elaborate on your answers as necessary.Name* First Last Email address* Nationality*Select your countryAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSaint MartinSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabweCountry code*Country codeAfghanistan +93Albania +355Algeria +213American Samoa +1-684Andorra +376Angola +244Anguilla +1-264Antarctica +672Antigua +1-268Argentina +54Armenia +374Aruba +297Ascension +247Australia +61Australian External Territories +672Austria +43Azerbaijan +994Bahamas +1-242Bahrain +973Bangladesh +880Barbados +1-246Barbuda +1-268Belarus +375Belgium +32Belize +501Benin +229Bermuda +1-441Bhutan +975Bolivia +591Bosnia & Herzegovina +387Botswana +267Brazil +55British Virgin Islands +1-284Brunei Darussalam +673Bulgaria +359Burkina Faso +226Burundi +257Cambodia +855Cameroon +237Canada +1Cape Verde Islands +238Cayman Islands +1-345Central African Republic +236Chad +235Chatham Island (New Zealand) +64Chile +56China (PRC) +86Christmas Island +61-8Cocos-Keeling Islands +61Colombia +57Comoros +269Congo +242Congo, Dem. Rep. of (former Zaire) +243Cook Islands +682Costa Rica +506Cote d'Ivoire +225Croatia +385Cuba +53Cuba (Guantanamo Bay) +5399Cyprus +357Czech Republic +420Denmark +45Diego Garcia +246Djibouti +253Dominica +1-767Dominican Republic +1-809 and +1-829East Timor +670Easter Island +56Ecuador +593Egypt +20El Salvador +503Equatorial Guinea +240Eritrea +291Estonia +372Ethiopia +251Falkland Islands (Malvinas) +500Faroe Islands +298Fiji Islands +679Finland +358France +33French Antilles +596French Guiana +594French Polynesia +689Gabonese Republic +241Gambia +220Georgia +995Germany +49Ghana +233Gibraltar+350Greece +30Greenland +299Grenada +1-473Guadeloupe +590Guam +1-671Guantanamo Bay +5399Guatemala +502Guinea-Bissau +245Guinea +224Guyana +592Haiti +509Honduras +504Hong Kong +852Hungary +36Iceland +354India +91Indonesia +62Iran +98Iraq +964Ireland +353Israel +972Italy +39Jamaica +1-876Japan +81Jordan +962Kazakhstan +7Kenya +254Kiribati +686Korea (North) +850Korea (South) +82Kosovo +383Kuwait +965Kyrgyz Republic +996Laos +856Latvia +371Lebanon +961Lesotho +266Liberia +231Libya +218Liechtenstein +423Lithuania +370Luxembourg +352Macao +853Macedonia (Former Yugoslav Rep of.) +389Madagascar +261Malawi +265Malaysia +60Maldives +960Mali Republic +223Malta +356Marshall Islands +692Martinique +596Mauritania +222Mauritius +230Mayotte Island +269Mexi +52Micronesia, (Federal States of) +691Midway Island +1-808Moldova +373Monaco +377Mongolia +976Montenegro +382Montserrat +1-664Morocco +212Mozambique +258Myanmar +95Namibia +264Nauru +674Nepal +977Netherlands +31Netherlands Antilles +599Nevis +1-869New Caledonia +687New Zealand +64Nicaragua +505Niger +227Nigeria +234Niue +683Norfolk Island +672Northern Marianas Islands +1-670Norway+47Oman +968Pakistan +92Palau +680Palestinian Settlements +970Panama +507Papua New Guinea +675Paraguay +595Peru +51Philippines +63Poland +48Portugal +351Puerto Rico +1-787 or +1-939Qatar +974Reunion Island +262Romania +40Russia +7Rwandese Republic +250St. Helena +290St. Kitts/Nevis +1-869St. Lucia +1-758St. Pierre & Miquelon +508St. Vincent & Grenadines +1-784Samoa +685San Marino +378Sao Tomo and Principe +239Saudi Arabia +966Senegal +221Serbia +381Seychelles Republic +248Sierra Leone +232Singapore +65Slovak Republic +421Slovenia +386Solomon Islands +677Somali Democratic Republic +252South Africa +27Spain +34Sri Lanka +94Sudan +249Suriname +597Swaziland +268Sweden +46Switzerland +41Syria+963Taiwan +886Tajikistan +992Tanzania +255Thailand +66Timor Leste +670Togolese Republic +228Tokelau +690Tonga Islands +676Trinidad & Tobago +1-868Tunisia +216Turkey +90Turkmenistan +993Turks and Caicos Islands +1-649Tuvalu +688Uganda +256Ukraine +380United Arab Emirates +971United Kingdom +44USA - United States of America +1US Virgin Islands +1-340Uruguay +598Uzbekistan +998Vanuatu +678Vatican City +39, +379Venezuela +58Vietnam +84Wake Island +808Wallis and Futuna Islands +681Yemen +967Zambia +260Zanzibar +255Zimbabwe +263Phone Number*Skype ID:Preferred Destination*Select destinationAmsterdamBulgariaEcuadorGhanaIndiaKosovoLong Beach, CALos AngelesMacedoniaMadridMaliMoroccoOrlando, FLPeruRomaniaSan FranciscoSilicon ValleySouth AfricaStockholmThailandUgandaUkraineVietnamPrimary field of interest*Secondary Field of InterestDate* Completed by*Name of Enterprise*WebsiteAddress* Street Address City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSaint MartinSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Social Enterprise Type*Non-profit 501(c)3For ProfitGovernment InstrumentalityNon-Profit otherPlease describe the type of nonprofit*President/CEO*Year Established*Select20182017201620152014201320122011201020092008200720062005200420032002200120001999199819971996199519941993199219911990198919881987198619851984198319821981198019791978197719761975197419731972197119701969196819671966196519641963196219611960195919581957195619551954195319521951195019491948194719461945194419431942194119401939193819371936193519341933193219311930192919281927192619251924192319221921192019191918191719161915191419131912191119101909190819071906190519041903190219011900Mission*DescriptionNumber of Employees*Select1-56-1011-3031-50Over 50Primary Contact Person* First Last TitleCountry code*SelectAfghanistan +93Albania +355Algeria +213American Samoa +1-684Andorra +376Angola +244Anguilla +1-264Antarctica +672Antigua +1-268Argentina +54Armenia +374Aruba +297Ascension +247Australia +61Australian External Territories +672Austria +43Azerbaijan +994Bahamas +1-242Bahrain +973Bangladesh +880Barbados +1-246Barbuda +1-268Belarus +375Belgium +32Belize +501Benin +229Bermuda +1-441Bhutan +975Bolivia +591Bosnia & Herzegovina +387Botswana +267Brazil +55British Virgin Islands +1-284Brunei Darussalam +673Bulgaria +359Burkina Faso +226Burundi +257Cambodia +855Cameroon +237Canada +1Cape Verde Islands +238Cayman Islands +1-345Central African Republic +236Chad +235Chatham Island (New Zealand) +64Chile +56China (PRC) +86Christmas Island +61-8Cocos-Keeling Islands +61Colombia +57Comoros +269Congo +242Congo, Dem. Rep. of (former Zaire) +243Cook Islands +682Costa Rica +506Cote d'Ivoire +225Croatia +385Cuba +53Cuba (Guantanamo Bay) +5399Cyprus +357Czech Republic +420Denmark +45Diego Garcia +246Djibouti +253Dominica +1-767Dominican Republic +1-809 and +1-829East Timor +670Easter Island +56Ecuador +593Egypt +20El Salvador +503Equatorial Guinea +240Eritrea +291Estonia +372Ethiopia +251Falkland Islands (Malvinas) +500Faroe Islands +298Fiji Islands +679Finland +358France +33French Antilles +596French Guiana +594French Polynesia +689Gabonese Republic +241Gambia +220Georgia +995Germany +49Ghana +233Gibraltar+350Greece +30Greenland +299Grenada +1-473Guadeloupe +590Guam +1-671Guantanamo Bay +5399Guatemala +502Guinea-Bissau +245Guinea +224Guyana +592Haiti +509Honduras +504Hong Kong +852Hungary +36Iceland +354India +91Indonesia +62Iran +98Iraq +964Ireland +353Israel +972Italy +39Jamaica +1-876Japan +81Jordan +962Kazakhstan +7Kenya +254Kiribati +686Korea (North) +850Korea (South) +82Kosovo +383Kuwait +965Kyrgyz Republic +996Laos +856Latvia +371Lebanon +961Lesotho +266Liberia +231Libya +218Liechtenstein +423Lithuania +370Luxembourg +352Macao +853Macedonia (Former Yugoslav Rep of.) +389Madagascar +261Malawi +265Malaysia +60Maldives +960Mali Republic +223Malta +356Marshall Islands +692Martinique +596Mauritania +222Mauritius +230Mayotte Island +269Mexi +52Micronesia, (Federal States of) +691Midway Island +1-808Moldova +373Monaco +377Mongolia +976Montenegro +382Montserrat +1-664Morocco +212Mozambique +258Myanmar +95Namibia +264Nauru +674Nepal +977Netherlands +31Netherlands Antilles +599Nevis +1-869New Caledonia +687New Zealand +64Nicaragua +505Niger +227Nigeria +234Niue +683Norfolk Island +672Northern Marianas Islands +1-670Norway+47Oman +968Pakistan +92Palau +680Palestinian Settlements +970Panama +507Papua New Guinea +675Paraguay +595Peru +51Philippines +63Poland +48Portugal +351Puerto Rico +1-787 or +1-939Qatar +974Reunion Island +262Romania +40Russia +7Rwandese Republic +250St. Helena +290St. Kitts/Nevis +1-869St. Lucia +1-758St. Pierre & Miquelon +508St. Vincent & Grenadines +1-784Samoa +685San Marino +378Sao Tomo and Principe +239Saudi Arabia +966Senegal +221Serbia +381Seychelles Republic +248Sierra Leone +232Singapore +65Slovak Republic +421Slovenia +386Solomon Islands +677Somali Democratic Republic +252South Africa +27Spain +34Sri Lanka +94Sudan +249Suriname +597Swaziland +268Sweden +46Switzerland +41Syria+963Taiwan +886Tajikistan +992Tanzania +255Thailand +66Timor Leste +670Togolese Republic +228Tokelau +690Tonga Islands +676Trinidad & Tobago +1-868Tunisia +216Turkey +90Turkmenistan +993Turks and Caicos Islands +1-649Tuvalu +688Uganda +256Ukraine +380United Arab Emirates +971United Kingdom +44USA - United States of America +1US Virgin Islands +1-340Uruguay +598Uzbekistan +998Vanuatu +678Vatican City +39, +379Venezuela +58Vietnam +84Wake Island +808Wallis and Futuna Islands +681Yemen +967Zambia +260Zanzibar +255Zimbabwe +263Phone*Email* Skype IDPreferred Method of ContactSelectPhoneEmailSkypeNo preferenceOther Contact PersonNoYesName* Mr.Mrs.MissMs.Dr.Prof.Rev. Prefix First Last TitleCountry code*SelectAfghanistan +93Albania +355Algeria +213American Samoa +1-684Andorra +376Angola +244Anguilla +1-264Antarctica +672Antigua +1-268Argentina +54Armenia +374Aruba +297Ascension +247Australia +61Australian External Territories +672Austria +43Azerbaijan +994Bahamas +1-242Bahrain +973Bangladesh +880Barbados +1-246Barbuda +1-268Belarus +375Belgium +32Belize +501Benin +229Bermuda +1-441Bhutan +975Bolivia +591Bosnia & Herzegovina +387Botswana +267Brazil +55British Virgin Islands +1-284Brunei Darussalam +673Bulgaria +359Burkina Faso +226Burundi +257Cambodia +855Cameroon +237Canada +1Cape Verde Islands +238Cayman Islands +1-345Central African Republic +236Chad +235Chatham Island (New Zealand) +64Chile +56China (PRC) +86Christmas Island +61-8Cocos-Keeling Islands +61Colombia +57Comoros +269Congo +242Congo, Dem. Rep. of (former Zaire) +243Cook Islands +682Costa Rica +506Cote d'Ivoire +225Croatia +385Cuba +53Cuba (Guantanamo Bay) +5399Cyprus +357Czech Republic +420Denmark +45Diego Garcia +246Djibouti +253Dominica +1-767Dominican Republic +1-809 and +1-829East Timor +670Easter Island +56Ecuador +593Egypt +20El Salvador +503Equatorial Guinea +240Eritrea +291Estonia +372Ethiopia +251Falkland Islands (Malvinas) +500Faroe Islands +298Fiji Islands +679Finland +358France +33French Antilles +596French Guiana +594French Polynesia +689Gabonese Republic +241Gambia +220Georgia +995Germany +49Ghana +233Gibraltar+350Greece +30Greenland +299Grenada +1-473Guadeloupe +590Guam +1-671Guantanamo Bay +5399Guatemala +502Guinea-Bissau +245Guinea +224Guyana +592Haiti +509Honduras +504Hong Kong +852Hungary +36Iceland +354India +91Indonesia +62Iran +98Iraq +964Ireland +353Israel +972Italy +39Jamaica +1-876Japan +81Jordan +962Kazakhstan +7Kenya +254Kiribati +686Korea (North) +850Korea (South) +82Kosovo +383Kuwait +965Kyrgyz Republic +996Laos +856Latvia +371Lebanon +961Lesotho +266Liberia +231Libya +218Liechtenstein +423Lithuania +370Luxembourg +352Macao +853Macedonia (Former Yugoslav Rep of.) +389Madagascar +261Malawi +265Malaysia +60Maldives +960Mali Republic +223Malta +356Marshall Islands +692Martinique +596Mauritania +222Mauritius +230Mayotte Island +269Mexi +52Micronesia, (Federal States of) +691Midway Island +1-808Moldova +373Monaco +377Mongolia +976Montenegro +382Montserrat +1-664Morocco +212Mozambique +258Myanmar +95Namibia +264Nauru +674Nepal +977Netherlands +31Netherlands Antilles +599Nevis +1-869New Caledonia +687New Zealand +64Nicaragua +505Niger +227Nigeria +234Niue +683Norfolk Island +672Northern Marianas Islands +1-670Norway+47Oman +968Pakistan +92Palau +680Palestinian Settlements +970Panama +507Papua New Guinea +675Paraguay +595Peru +51Philippines +63Poland +48Portugal +351Puerto Rico +1-787 or +1-939Qatar +974Reunion Island +262Romania +40Russia +7Rwandese Republic +250St. Helena +290St. Kitts/Nevis +1-869St. Lucia +1-758St. Pierre & Miquelon +508St. Vincent & Grenadines +1-784Samoa +685San Marino +378Sao Tomo and Principe +239Saudi Arabia +966Senegal +221Serbia +381Seychelles Republic +248Sierra Leone +232Singapore +65Slovak Republic +421Slovenia +386Solomon Islands +677Somali Democratic Republic +252South Africa +27Spain +34Sri Lanka +94Sudan +249Suriname +597Swaziland +268Sweden +46Switzerland +41Syria+963Taiwan +886Tajikistan +992Tanzania +255Thailand +66Timor Leste +670Togolese Republic +228Tokelau +690Tonga Islands +676Trinidad & Tobago +1-868Tunisia +216Turkey +90Turkmenistan +993Turks and Caicos Islands +1-649Tuvalu +688Uganda +256Ukraine +380United Arab Emirates +971United Kingdom +44USA - United States of America +1US Virgin Islands +1-340Uruguay +598Uzbekistan +998Vanuatu +678Vatican City +39, +379Venezuela +58Vietnam +84Wake Island +808Wallis and Futuna Islands +681Yemen +967Zambia +260Zanzibar +255Zimbabwe +263Phone*Email* Skype IDPreferred Method of ContactSelectPhoneEmailSkypeNo preference EducationNoneYes, OneYes, TwoYes, ThreeYes, FourYes, FiveCollege/University 1*From* To* Major*MinorNumber of semester units/credits completed*GPA*College/University 2*From* To* Major*MinorNumber of semester units/credits completed*GPA*College/University 3*From* To* Major*MinorNumber of semester units/credits completed*GPA*College/University 4*From* To* Major*MinorNumber of semester units/credits completed*GPA*College/University 5*From* To* Major*MinorNumber of semester units/credits completed*GPA*Languages spoken and fluency levelNoneYes, OneYes, TwoYes, ThreeYes, FourYes, FiveLanguage 1*Fluency level*BeginnerFunctionalFluentNativeLanguage 2*Fluency level*BeginnerFunctionalFluentNativeLanguage 3*Fluency level*BeginnerFunctionalFluentNativeLanguage 4*Fluency level*BeginnerFunctionalFluentNativeLanguage 5*Fluency level*BeginnerFunctionalFluentNativeWork experienceNoneYes, OneYes, TwoYes, ThreeYes, FourYes, FiveEmployer Name 1*From* To* Title/Role*Primary responsibilities*Key achievements (if applicable)Skills Gained*Employer Name 2*From* To* Title/Role*Primary responsibilities*Key achievements (if applicable)Skills Gained*Employer Name 3*From* To* Title/Role*Primary responsibilities*Key achievements (if applicable)Skills Gained*Employer Name 4*From* To* Title/Role*Primary responsibilities*Key achievements (if applicable)Skills Gained*Employer Name 5*From* To* Title/Role*Primary responsibilities*Key achievements (if applicable)Skills Gained*Volunteer ExperienceNoneYes, OneYes, TwoYes, ThreeYes, FourYes, FiveTitle/Role 1*From* To* Primary responsibilities*Key achievements (if applicable)Key learning from experience*Skills Gained*Title/Role 2*From* To* Primary responsibilities*Key achievements (if applicable)Key learning from experience*Skills Gained*Title/Role 3*From* To* Primary responsibilities*Key achievements (if applicable)Key learning from experience*Skills Gained*Title/Role 4*From* To* Primary responsibilities*Key achievements (if applicable)Key learning from experience*Skills Gained*Title/Role 5*From* To* Primary responsibilities*Key achievements (if applicable)Key learning from experience*Skills Gained*Military ServiceNoYesFrom* To* Title/Role*Primary responsibilities*Key achievements (if applicable)Key learning from experience*Skills Gained*What is the reason you are filling out this Form?*I am interested in a volunteer internI am interested in a volunteer Entrepreneur-in-ResidenceI am interested in developing a partnership with Change UniversityLocation of internship*Where (city/country) would your EIR be working?*Number of Impact Interns Desired*Select12345 or moreWhy are you interested in a ChangeU EIR?*When would you like the intern to begin work?*SelectSummer (June - August; 10-12 weeks)Fall (August - December; 12-16 weeks)Spring (January - May; 12-16 weeks)No preferenceWhen would you like your EIR to begin work?*SelectSummer (June - August; 10-12 weeks)Fall (August - December; 12-16 weeks)Spring (January - May; 12-16 weeks)No preferenceFor how long would you like to take on an Impact Intern?*Select8 weeks10 weeks12 weeks16 weeks20 weeks24 weeksLonger than 24 weeksDoes not matterHow many weeks would you like your EIR to work for your social enterprise?*Select8 weeks10 weeks12 weeks16 weeks20 weeks24 weeksLonger than 24 weeksDoes not matterNumber of Supervisors*Select123Supervisor 1* First Last TitleSupervisor 2* First Last TitleSupervisor 3* First Last TitleWould the Impact Intern be working primarily alone or with one or more employees?*SelectMostly working aloneMostly working with one or more employeesHalf-time alone; half-time with othersNot sure yetWould your EIR be working primarily alone or with one or more employees?*SelectMostly working aloneMostly working with one or more employeesHalf-time alone; half-time with othersNot sure yetWould your EIR be supervised?*SelectNoYes (Please specify)Please specify*Why would you like to take on an Impact Intern?*What would be the tasks/activities of your EIR?*Which type(s) of accommodation best describes the housing situation of your Impact Intern?*SelectPrivate bedroom in a shared accommodationShared bedroomPrivate bedroomApartments - shared bedroomApartments - private bedroomFamily home-stayResidence hallsStudent Housing (private bedroom)Student Housing (shared bedroom)Not sure yetWhy are you interested in developing a partnership with Change University?*What role do you foresee Change University having in this new partnership?* What role do you foresee your social enterprise having in this new partnership?*Additional Comments:What do you hope the EIR will have accomplished by the conclusion of the his/her time with your social enterprise?*What skills would the Impact Intern learn?*What skills and/or expertise are you looking for in your EIR?*What do you hope the Impact Intern will have accomplished by the conclusion of the internship?*What personal qualities are you looking for in your EIR?*What skills and/or expertise are you looking for in your Impact Intern?*What personal qualities are you looking for in your Impact Intern?*Does your Impact Intern need to be proficient in any language other than English?*SelectNoYes (Please specify)Does your EIR need to be proficient in any language other than English?*SelectNoYes (Please specify)Please specify*Does your Impact Intern need prior experience in any particular area*SelectNoYes (please specify)Not required, but preferred (please specify)Does your EIR need prior experience in any particular area?*SelectNoYes (please specify)Not required, but preferred (please specify)Please specify*Which type(s) of accommodation best describes the housing situation of your EIR?*SelectPrivate bedroom in a shared accommodationShared bedroomPrivate bedroomApartments - shared bedroomApartments - private bedroomFamily home-stayResidence hallsStudent Housing (private bedroom)Student Housing (shared bedroom)Not sure yetOther considerations/commentsPlease comment below about anything else you want ChangeU to know about the type of EIR you desire for your social enterprise?Are you applying to be an Impact Intern or an Entrepreneur-in-Residence?*Impact InternEntrepreneur-in-ResidenceWhen would you like to start your internship?*SelectJanuary 5thFebruary 2ndMarch 2ndApril 6thMay 4thJune 1stJune 15thJuly 6thAugust 3rdSeptember 7thOctober 5thNovember 2ndDecember 7thWhen would you like to start working as an EIR?*SelectJanuary 5thFebruary 2ndMarch 2ndApril 6thMay 4thJune 1stJune 15thJuly 6thAugust 3rdSeptember 7thOctober 5thNovember 2ndDecember 7thFor how many weeks would you like to be an Impact Intern (check all that are possible)?* Select All 8 weeks 10 weeks 12 weeks 16 weeks 20 weeks 24 weeks For how many weeks would you like work as an EIR? (check all that are possible)* Select All 8 weeks 10 weeks 12 weeks 16 weeks 20 weeks 24 weeks Please describe your interest in purpose-driven enterprises (ie, for profits and nonprofits that strive to solve social problems) and your motivation for desiring a ChangeU internship?*Please describe your interest in purpose-driven enterprises and your motivation to work for a social enterprise?*What work-related skills or strengths do you possess that make you an excellent candidate for a ChangeU internship?*What is your main area of expertise that you would like to share with a ChangeU social enterprise?*What personal qualities do you possess that make you an excellent candidate for an ChangeU internship?*What work-related skills and strengths do you possess that would add significant value to a social enterprise?*What do you hope to learn from your ChangeU internship?*What personal qualities do you possess that make you an excellent candidate for an ChangeU internship?*In what ways can you contribute to the growth of the social enterprise at which you would be interning?*In what ways can you contribute to the growth of the social enterprise at which you would be working?*What would you most like the Selection Committee to know about you that would help them make a decision about your application?*What would you most like the Selection Committee to know about you that would help them make a favorable decision on your application?*Upload your CVWhen would you like to schedule your interview? ChangeU will work to accommodate your interview date/time request Choose a date* Choose a time*15:0015:3016:0016:3017:3018:0018:3019:0019:30Timezone: Pacific time (GMT-7:00)Program Fee* I understand that if my application is accepted and I choose to participate in the ChangeU program, there is a program fee.
