ECLOC Collaborative Intake Form

The Early Childhood Leaders of Color Collaborative is a national, self-organized network for leaders of color in early childhood. Please complete the form below to share a bit about yourself so that we can welcome you and get you onboarded into the Collaborative.

The Early Childhood Leaders of Color Collaborative is a national, self-organized, self-determined network for leaders of color in early childhood (pre-natal to 5+ years old) that affirms the experiences of EC LOC and centers liberation as our end goal. The Collaborative:

Provides opportunities for fellowship, shared dreaming, restoration, and healing.
Uses collective power to advocate for transformative policy and funding changes.
Engages in culturally responsive and equity-centered capacity building and professional development.
Uses stories and narrative power to learn from each other and educate funders and policymakers .

Are you ready to join our community focused on bringing this vision to life?

Yes, I am aligned to this vision and ready to join the Collaborative!No, I'm not aligned at this time.

Do you identify as a Leader of Color in the Early Childhood Ecosystem?

YesNo

How do you identify?

How do you identify racially/ethnically?

American Indian, Native American or Alaskan Native (e.g. Aztec, Blackfeet Tribe, Mayan, etc.)Asian, Native Hawaiian or Pacific Islander (e.g. Indian, Chinese, Fijian, etc.)Black or African American (e.g. Ethiopian, Haitian, Jamaican, etc.)Latinx or Hispanic (e.g. Dominican, Mexican, Peruvian etc.)White (e.g. Algerian, English, etc.)Multiple racesPrefer not to saySelect all that apply.

Which gender do you identify with?

Which pronouns do you use?

About You

First Name

Last Name

Email

Street

City

State

Zip

Organization

Search for your organization and enter the name in full if it is not in the existing list.

Title/Role

Organization Website

Which area of Early Childhood does your organization's work most/primarily drive impact in?

Other Early Childhood area of impact:

Programming and Offering Insights

The insights shared below will help the Early Childhood Leaders of Color Collaborative Working Group better determine and design programming and other offerings for Collaborative members in support of our vision. Details and additional color are very helpful!

Which of the following would be helpful for you?

Other helpful areas:

For any areas you selected above, please share more.

Ex: For peer-to-peer support, what might peer-to-peer support look like? Are there areas of your work you're most eager to gather wisdom on? Are there types of peers you're specifically looking for more support from?

Ex: For community-building with other BIPOC leaders, how might community building be most effective for you? Are there methods of communicating you prefer? Are there specific leaders you're eager to build community with?

Ex: For access to experts in the field: Which experts would you love to hear from? Are there specific domains you're most interested in learning about?

Ex: For skill-building, what specific skills are you most eager to dive into?

How do you hope to co-create or contribute your own ideas or skills to the collaborative?

Anything else you’d like to share?

Are you familiar with the Promise Venture Studio Network and the supports it can offer to social ventures and leaders in Early Childhood Development?

I am familiar, my organization is in it, and I feel comfortable accessing its support and resourcesI am familiar, but I want to learn more about how to access supports and resourcesI am not familiar and I'd like to learn moreI am not familiar but I don't want to learn more right now

Self-mantra questions (pre-survey)

For each of our Mantras of Success, please share your level of agreement for how much the statement applies to you as of today.

These Mantras of Success were self-determined and co-created by the EC LOC Planning Committee as a way to give voice to the intended impact that the EC LOC Collaborative might have on individual members, the Collaborative community and the ECD ecosystem as a whole.

	Strongly Agree	Agree	Disagree	Strongly Disagree
I have a community of peers in Early Childhood where I feel a sense of belonging.
I feel validated and respected in the field of Early Childhood.
I feel like I have space and time for rest and restoration.
Our Early Childhood Leaders of Color community is organized.
Our Early Childhood Leaders of Color community has set priorities.
Our Early Childhood Leaders of Color community is building a new future and reality for ourselves as leaders and those we serve.
Early Childhood Leaders of Color are collectively standing in our power and shifting power back to ourselves and our communities.
Early Childhood Leaders of Color are transforming the landscape in early childhood.

Thanks for your interest!

We hope we can connect with you again in the future.

In the meantime, if you're a social entrepreneur that's not yet in the Promise Venture Network, consider connecting join the Promise Venture Network or subscribing to our newsletter.