COMMUNTY PARTNER FORM

Primary Contact Name *

First Name

Last Name

Type of Organization *

Nonprofit

Faith Community

Educational Institution

Business with a Compassionate Mission

Other

Phone *

Country

(###)

###

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Which of our core aims resonate with your work? *

Checkboxes – allow multiple selections

Belonging Without Othering

Civic Participation

Cross-Difference Collaboration

Shared Power & Storytelling

All of the above

Other

How would you like to engage with The Change Lab *

Checkboxes – allow multiple selections

Share your organization's information

Collaborate on a pop-up, training, dinner, or storytelling project

Help develop The Civic Impact Engine

IN-KIND Support

OTHER

Do you affirm the following values? *

Welcome to The Change Lab. This agreement outlines the shared commitments and expectations between you (“Community Partner”) and The Change Lab, a project dedicated to building civic connection, shared understanding, and actionable pathways toward lasting social change. By joining as a Community Partner, you agree to the following: Our Shared Purpose The Change Lab exists to nurture a national movement of people and organizations committed to bridging divides, addressing root causes of inequality, and co-creating a better future for all. As a Community Partner, you join a growing ecosystem rooted in civic imagination, collaborative action, and systems change. We believe in starting from where we are, using what we have, and building from the ground up—with hope, humility, and accountability. Community Values As a Change Lab Community Partner, you commit to upholding and modeling our core values: Belonging We expand the circle of human concern and ensure everyone feels seen, heard, and valued. Curiosity We engage with openness and a willingness to learn from different perspectives. Courage We face complexity with honesty and are unafraid to challenge injustice or try new approaches. Accountability We honor our commitments, measure impact, and learn from outcomes—good or bad. Collaboration We share power, build trust, and design solutions together—especially across lines of difference. Imagination We believe a better future is possible—and work every day to make it real. Your Role as a Community Partner Be a Connector: Share ideas, insights, opportunities, and lived experience. The Change Lab is stronger when we learn from one another. Engage Actively: Participate in pilot programs, contribute to conversations, or test new tools. Help shape and scale what works. Share Credit and Responsibility: We succeed by lifting each other up—and by taking ownership when things need to improve. Respect the Space and People: Whether virtual or in-person, we expect all engagement to reflect mutual respect, empathy, and care. Terms of Partnership This agreement does not establish a legal partnership or lease. Rather, it signifies your participation in a values-based network with defined activities, offerings, and opportunities. Community Partnership may be revoked or paused if behaviors contradict the spirit or values of this agreement. Your participation signifies that you accept and agree to the most current version of this agreement. Effective Date This agreement takes effect upon mutual acknowledgment by The Change Lab and the Community Partner. By participating in your first Change Lab project, conversation, or event, you affirm your acceptance of these terms. Let us build something meaningful—together. The Change Lab Connection is the remedy. Action is the path.

YES

NO

Date

MM

DD

YYYY

How would you like to contribute to this partnership? *

We believe cost should never be a barrier to connection, collaboration, or contribution. That’s why The Change Lab offers a Pay What You Want partnership model. Whether you're an under-resourced grassroots group, a community-focused business, or a well-funded nonprofit, you’re welcome here. Some partners give $1, some give $10,000, others give more — and many support in non-financial ways, like hosting gatherings, lending skills, or sharing their network. You decide what’s possible. Whatever you choose, you’ll be met with respect, curiosity, and the belief that we’re building something meaningful — together. If you’d like to talk through what contribution looks like for you, we’re happy to have that conversation.

Financial Contribution

In-kind support (facilitation, space, volunteers, design, etc.)