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Primary Contact Name:
Alternate Business Contact
What type of organization describes your organization:
Impact Investment Organization / Fund
If selected Non-Governmental Organization, Enterprise or Foundation, please answer yes/no to the following:
Is your organization interested in collaborating with others in the social impact space? If yes, please describe what type of partnership would you be interested in.
If yes, please describe in the field below
Where does your organization fall within the blockchain for social impact journey with Ethereum?
Exploring potential solutions
Looking to learn about the potentials
Looking to develop a solution and your organization has dedicated funding
As a member of BSIC, my organization is willing to work with the technologists/social entrepreneurs to develop Concepts, Use Cases, and Product Market of a blockchain solution.
My organization is already funding, developing, or deploying a blockchain solution, or has a very clear roadmap for doing so in the near future.
Which of the following will your organization satisfy? Select all that apply.
A viable blockchain solution with foreseeable impact
A strong team with exceptional execution capability
A well-established organization with a developed client base
Willing to pitch in speakers, venues, thought leadership, sponsorship dollars, in-kind donation, etc.
Complementary to and willing to collaborate with existing members
BSIC is a member community and we hope that membership will be willing to participate in supporting the community. In which ways would your organization willing to offer community support?
Payment in kind
Working group champion
What is the focus of the social impact project(s) that you are currently working on? Please provide details on what the project is along with a brief description, outcome and geography.
Is there a direct mandate from your c suite to engage in block for social impact decisions?
What role do you play in your organizations ability to make funding decisions in blockchain?