application | Mosaic Advisory Cohort Name * First Name Last Name Pronouns Company/Organization * Role/Title * Primary Email * Alternative Email An email where we can reach you should you lose access to your primary email. LinkedIn Profile Link Location * Where will you be joining us from? City/State/Country Marketing * How did you hear about the MAC program? Answering this helps us better reach others who might need what we're doing. Access Needs What can we do to help you show up fully present and ready to engage? Group Diversity * We are striving for a diverse group and may explore affinity groups if desired by participants. Please share identities you hold as it relates to race/ethnicity, gender, orientation, age, neurotype, and ability. Cohort Track * I want to join the following cohort tracks: People Managers: Managing for Inclusion Equity (DEI) Leaders: Crafting the Workplace for Equity Both Cycle * Please select the cycle you're applying for below. Summer: April to June, 2024 Fall: September to October, 2024 Spring: February to March, 2025 Payment Profile * Corporate - my corporate/for-profit employer is funding my participation. Nonprofit - my nonprofit/NGO employer is funding my participation. Self-Pay - I am paying for my own participation. Corporate - Full Pay Upfront Nonprofit - Full Pay Upfront Self-Pay - Full Pay Upfront Self-Pay - 2-payment Payment Plan Mosaic Client * A client discount rate is available where applicable. Are you a previous/current Mosaic client? Yes No Message * Anything more you'd like to ask or share with us? Do so here. Thank you for applying. We’ll be in touch soon. Got questions? Email us at info@mosaic4equity.com - include the words “MAC HELP” in the subject line.
