Before you begin, please take a moment to review the following:

Only one person per organization should complete this form. Please coordinate with your team to ensure no one else is completing or planning to complete.

The person completing this form should be able to lead the entire process for your organization. If the primary point of contact changes at any point, please notify us right away at [email protected].

Each grantee will receive 10 hours of free 1:1 support to help implement the recommended actions.

This program runs from May 2025 through October 2025. All recommendations must be implemented by October 31, 2025.

You do not need to have all the answers—please answer honestly so we can identify any digital security gaps.

If you have any questions or need support, please reach out to us at [email protected]

Primary Contact

First Name:

Last Name:

Email:

Organization Details

Organization Name:

Address:

City:

State:

Postal Code:

Website URL: