IMB Pledge Qualification Form
The process to apply, qualify and be considered for this $100,000 fund appropriation will entail submissions of this ‘IMB Pledge Qualification Form’ which will be collected immediately through January 2019 and reviewed in February 2019 by the founders and board members of the company. Non Profit Organizations, Charities, Institutions and Individuals that have shown measurable success in past and have demonstrated their community building efforts and accomplishment are encouraged to submit their applications before the deadline of January 31st, 11.59pm IST. Any additional inquiries about the pledge, the process and purpose can be sent via email to ceo@imbesharam.com.

Email *
Organization/Institution/Self Name: *
Website URL of your Organization/Institution/Self *
What do you do for the upliftment of the LGBT+ community in India? (Answer in details) *
What have you done in the past towards the betterment and welfare of the LGBT+ community? (Answer in details and include articles, photos, videos, weblinks and all such supporting documents that show your past efforts) *
What is on agenda for 2019? *
What activities/campaigns/efforts you plan to accomplish if you qualify for receiving the grant. *
How much grant would you seek to accomplish above goals? *
Required
What would you need/use these funds for? (State exactly what/how/when) *
Do you have any referrals from well known reputed people/public figures who have been part of your efforts in past or who help you at this time? *
By when do you wish to implement your plan for action? *
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If we have to choose between the Top 10 applicants, what is it that you will do/have done which should be given a preference over others? *
Who are the stake holders in your organization (Name, Email, Linkedin Profile, Mobile #) *
Are you a registered organization? If so please hare details of your registration/certification (attach your incorporation/registration certificate) *
How did you hear about this activity? *
What is your name and your position in your organization? *
Share any additional documents or links you would like to for us to consider when evaluating your application
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