PILOT 2019-20 Application
Sign in to Google to save your progress. Learn more
Thank you for being interested in participating in PILOT's 2019-20 cohort and taking the time to fill out the application. Please answer the following questions in order to complete the PILOT application process. The last day to apply is September 15th, 2019.

PILOT Participant Qualifications:
Direct experience as an immigrant, refugee, or asylee or as the child of an immigrant, refugee, or asylee
Willingness to learn in a safe space where we respect and honor the views and opinions of people from diverse backgrounds
Passion for social change and serving the community
Able to participate in ALL convenings (dates below)

English is not required, and interpretation can be provided.

All program costs are covered. While Unite Oregon spends approximately $6,000 per participant, the program is free of charge to participants. Therefore, we require that all participants commit to the whole program and sign a Personal Agreement with Unite Oregon.

Training Dates (Must attend ALL):
October 4-6th Weekend Retreat (Location TBA, Transportation Provided)
December 8
February 1-2 (Weekend)
April 4 (Saturday)
May 30 Final Meeting and Graduation Dinner (Saturday)

If you have any question, please reach out to Seemab Husseini at seemab@uniteoregon.org or 503-832-0994.
First Name *
Last Name *
Email address *
Street Address *
City, State and Zipcode *
Phone Number *
What Best Describes You *
Country of Origin : *
Ethnicity (for example, Latinx, Slavic, Persian): *
Gender *
Are you under 18? *
What language(s) do you speak? *
Do you need language interpretation? If so, what language? *
Do you have any dietary needs? *
Do you need any disability/accessibility accommodation? If so, what? *
Do you need childcare? *
PILOT Questions
We want to get to know you better. Please answer the questions below.
1. Have you ever attended a leadership development training in the past? If so, what kind? What did you learn? *
2. What are you hoping to get out of the Pan-Immigrant Leadership and Organizing Training (PILOT) Program: what skills do you feel you are good at? What skills would you like to make stronger? *
3. Please share how you work with immigrant and refugee communities, either in your own community or cross-culturally. *
4. What do you feel are the three most challenging issues that immigrants and refugees in your community are facing and why do you think so? *
5. What does liberation look like to you and your community? How do we get there? *
6. We believe in movement spaces where people can bring their whole selves and practice self-preservation. What does wellness and healing mean or look like for you?
7. Is there anything else you want to tell us about yourself? Do you have any questions for us?
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Unite Oregon. Report Abuse
Google Forms