fill this out to become an affiliate. Contact name (1) * email * Tell us why you are interested * Location * Where is your affiliate located? Organization/Collective Name * Contact Name (2) * Phone (1) * Phone (2) * Website Other Members/Persons Interested in Becoming an INCITE! Affiliate (at least 3 persons): * Geographic Community & Demographics * Rural Reservation Prison Urban College Campus Suburb How would you describe the community/area your affiliate would represent/organize with? What are the women & transpeople of color demographics of your community/ what are the major racial/ethnic groups in your community? * You can include: race, economic status, national origin, immigration status, sexual preference, gender identity, and age What are the major issues/forms of violence and oppression women of color and trans people of color experience in your community? * What are the primary challenges/issues in your community? (Examples: lack of reproduction education, anti-welfare and immigration policies, lack of affordable housing/no tenant rights policies; limited healthcare access; poor working/labor conditions; increased law enforcement violence; high rates of intimate partner/sexual abuse; high rate of violence against LBGTTSQ communities of color and limited resources, lack of leadership development for youth, etc) What areas/forms of violence your collective/organization would like to address/ or is addressing: * Reproductive Health & Justice Gender Based Violence Economic Justice Gender/Trans Justice Youth Organizing Law Enforcement Violence Community Accountability Prison Abolition Racial & Gender Health Disparities Immigrant & Refugee Rights Sovereignty & Indigenous Rights War & Militarism HIV/AIDS Organizing Other: What are 3 barriers, obstacles, or limiting factors you think you will face implementing your affiliate’s goals and projects? * Please indicate how the INCITE! National Collective could work with your affiliate/collective * Grassroots Fundraising Grassroots Organizing & Base Building Leadership Development Affiliate Coordination Membership Development Technical Assistance Collective Building Other Where possible, specify suggested activities CAPTCHAThis question is for testing whether you are a human visitor and to prevent automated spam submissions. Math question * 2 + 1 = Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.