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Project ID

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Project Number

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Project Name

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Corporate Client

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Logistics Coordinator Name

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Logistics Coordinator Email

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Program Manager Name

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Program Manager Email

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Thank you for your interest in being a host client for the upcoming AI for Impact program! Please take a moment to read through the information below and ensure that your organization can meet each of the requirements. If you have any questions, please feel free to ask your PYXERA Global Program Manager.

In this survey, we will ask a few questions about your organization and the key points of contact. We also ask you to submit up to three realistic project proposals that would be beneficial to your organization at this time. We take time to carefully review all proposals to determine if your organization might be a good fit for this program. We will contact you directly after we have reviewed all proposals.

Please note that you can return to complete the survey at a later point if you access the survey on the same device and same browser; however, we recommend you complete it in one sitting. A summary of your responses will be sent to you after completing the survey.

Program Information: No financial assistance is provided to local clients for participation in the AI for Impact program.

Program Requirements: To participate in the AI For Impact, we ask selected local clients to accommodate the following:
Access to decision-makers for at least 2 hours per week for the duration of the assignment.
An English-speaking representative familiar with the project to be the pro bono consultants’ liaison during their assignment, if applicable (please confirm with your program manager)
If you have any questions on the above items, please feel free to contact the Program Manager.

Thank you again for your interest! We look forward to working with you and reviewing your proposal.

Organization Information

Full Organization Name

Website

Street

City

State/Province

Zip/Postal Code

Country

Primary Contact

This person will lead in developing the project and be the main point of contact for the consultants during project implementation.

First Name

Last Name

Title/Position

Email

Phone Number

How many hours per week can your Project Coordinator dedicate to the project?
Generally, we expect a commitment of at least 10 hours per week.

Organization Legal Structure
Please select only one of the below options

Sole ProprietorshipNonprofitFoundation Social EnterprisePartnershipCorporationLimited Liability CompanyEducational InstitutionGovernmentOther

Other Organization Legal Structure

Number of employees

1-10 employees11-50 employees51-200 employees201-500 employees501-1000 employees1001+ employees

Year of Organization Founding

Sector Activities
Please select the top three

Agriculture	Artisan/Handicraft
Business Support/Services	Conflict Prevention & Recovery
Culture	Disaster Resilience &Recovery
Economic Development	Education
Employment Services	Energy
Environment/Sustainability	Financial Services
Food Security	Governance/Public Policy/Advocacy
Health	Housing Development
Information and Communications Technology	Infrastructure/Facilities Development
Manufacturing	Racial and Social Justice
Research & Development	Social Services/Social Work
Supply Chain Services/Logistics	Transportation
Water	Other

Other Sector Activities

Target Clients/Community Members
Your target clients or community members are those people your organization serves. They either consume your products and services or benefit directly or indirectly from the activities of your organization

WomenGirlsPregnant PeopleChildren (0-17 y.o.)Young Adults (18-35 y.o.)Older Adults (60+)Underrepresented Ethnic or Racial GroupIndigenousPeople with DisabilitiesPeople with Chronic Diseases/IllnessesDisaster/Conflict AffectedFood Insecure PeopleHousing Insecure PeopleEconomically Disadvantaged PeopleUnemployedImmigrants/MigrantsRefugees/Asylees/Displaced PeopleVeterans/MilitaryIncarcerated/Formerly IncarceratedLGBTQIA+Other

In what countries are your target community members located?

In what cities or regions are your target community members located?

Approximately how many community members does your organization serve in your country or region (please specify)?

Approximate prior year operating budget (in USD)

Approximate current year operating budget (in USD)

Growth rate of revenue or funds raised over previous three years

If your organization has experienced growth or loss in revenue or funds raised during the last three years, please select a corresponding answer.

GrowthNo ChangeLoss

Please further explain your answer
Describe the growth or loss your organization has experienced over the last three years.

Profit or loss for previous fiscal year
Did you operate at a profit or loss last year? What key factors contributed to this profit or loss? Explain.

Organization Mission and Vision Statement
If your organization has a stated mission and vision, please insert it here.

Organizational Description
Who are you? What is the objective of your organization? What are your main sources of funding? Highlight any key programs, services, or products?

Primary Partners
Who are your current partners in terms of funding and programming? Please add 1-2 sentences on how these partners support the organization.

Primary Competitors
Please list some of your main competitors, if applicable.

What current technology/data/AI tools do you use within your organization (if any)

Do you have staff or volunteers focused on digital/data/AI? (If so, please share their primary role within your organization)

Previous Experience with Consultants
Do you have previous experience hosting or working with consultants? If you do, please explain the experience.

How many project applications would you like to submit today?
Please write a number between 1 and 3.

As part of your application, please submit up to three projects (opportunities or challenges), in order of importance, that your organization would like to address with AI.

Projects may address challenges in any of the following areas:
Organizational Readiness, Change & Strategy: Evaluating digital/AI preparedness, managing technology change, designing staff enablement programs, or supporting adoption of new AI-related processes.
Governance, Ethics & Risk: Building policies for responsible AI use, mapping data governance requirements, or creating frameworks to evaluate and mitigate risks.
Implementation & Operationalization: Improving operational efficiency, planning for step-by-step integration of AI tools; piloting workflows, protocols, or automation in live nonprofit settings.
User Experience (UX) Guidance & Communications Plans: Streamlining how stakeholders interact with new technology, improving digital communications, or designing community awareness campaigns for digital adoption.

We encourage you to frame your project ideas as “How might we…?” questions that would stretch your organization’s impact and leverage the expertise of our AI and digital volunteers.

Problem Statement #1

In two to four sentences, describe the most pressing organizational challenge you hope to address. What support or expertise are you seeking from the AI for Impact volunteer team? What would success look like—please share expected outcomes and deliverables.

Example: How might we use AI to anticipate service demand and optimize volunteer assignments across our network?

Background & Information

Provide any relevant context for the challenge. Why is this issue important to your organization right now? What previous attempts have you made to address it, and what has (or has not) worked?

Problem Statement #2

In two to four sentences, describe the most pressing organizational challenge you hope to address. What support or expertise are you seeking from the AI for Impact volunteer team? What would success look like—please share expected outcomes and deliverables.

Example: How might we assess our organization’s readiness for AI and design effective staff training so our programs remain innovative and resilient?

Background & Information

Provide any relevant context for the challenge. Why is this issue important to your organization right now? What previous attempts have you made to address it, and what has (or has not) worked?

Project Information 3

Problem Statement #3

In two to four sentences, describe the most pressing organizational challenge you hope to address. What support or expertise are you seeking from the AI for Impact volunteer team? What would success look like—please share expected outcomes and deliverables.

Example: How might we create a governance policy and risk framework to ensure ethical and responsible use of AI across our organization?

Background & Information

Provide any relevant context for the challenge. Why is this issue important to your organization right now? What previous attempts have you made to address it, and what has (or has not) worked?

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