Nominate an Ashoka Young Changemaker

Are you nominating yourself?

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ABOUT YOU

First Name

Last Name

Your Email

How did you hear about the person you are nominating?

How long have you known this candidate for?

Tell us why you are nominating this candidate? What inspired you to nominate the candidate?

Should we send you periodic updates about Ashoka & opportunities to engage?

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ABOUT THE NOMINEE

First Name

Last Name

Country of Residence

City

State

Date of Birth

Preferred Email

Phone Number

Please copy paste any link that contain stories, profile, news, or any information that helps us understand the candidate better.

Anything else you’d like us to know?

ABOUT YOU

First Name

Last Name

Gender

Date of Birth

Phone

Country of Residence

Street

City

State

Province

State / Province

Zip/Postal Code

Education level

Name of your Changemaker Initiative

What field/area is your initiative focused on?

What is the problem you are trying to address?

What is your idea to address the problem?

How long have you been working on this problem?

Do you work with a team?

YesNo

How many fully committed team members do you have?

How does your team support you in reaching your goals?

What impact have you had to date?

How many people have been impacted by your idea (approximately)?

You are a Changemaker… What are you ideas to help other young people become Changemakers like you?

Please share any links that you might have that contain stories, profile, news, or any information about you and your work.

Any other things you want us to know?

Should we send you periodic updates about Ashoka & opportunities to engage?

YesNo

Hidden Fields

System Log

Owner

Campaign TFA ID

Contact Information