Tell us about your organization or your organization's concept and purpose: *

Tell us about the rare disease population you currently serve or plan to serve: *

Describe your current status as an organization: *

Tell us about your recent leadership experience either through a job or as a volunteer:

What is your timeframe?

Tell us about the areas of support you are seeking? (check all that apply) *
Strategy / Strategic PlanningRegistration (business and nonprofit)Operations (Processes, Organizational Design, etc)Financials (Budgeting, Accounting, Planning)Diversity, Equity, InclusionDevelopment / FundraisingMarketing / CommunicationsBoard DevelopmentAdvisory Committee DevelopmentStaff DevelopmentVolunteer Recruitment and/or DevelopmentOther (please describe)

Your Name: *

Email address: *

Phone: *

Mailing Address: *

Role of Applicant: (check all that apply) *
FounderExecutive Director/CEO/PresidentStaff MemberBoard MemberVolunteerOther

Organization Name: *

If an existing organization, provide your EIN:

As a program applicant, I understand the following:
Participating organizations share in Upequity’s intent to serve and support rare and chronic disease communities and advance health equity.Applicants with founders or leaders who are individuals from underrepresented communities or that serve a rare community where there is a high prevalence of underserved members are considered priority applications.RareInc services and support framework are customized to focus on meeting individualized participant organization needs.RareInc functions as a collaborative partnership. Respect, trust and confidentiality is expected and adhered to in both directions.Participant organizations are assigned a primary coach, but other team members may advise at times to best assist.Micro-grant opportunities may become accessible throughout each calendar year based on program funding but are not guaranteed as a part of the program.