Ashoka Young Changemakers | Nigeria

Ashoka Young Changemakers | Nigeria | Nomination Form

1. Are you nominating yourself?

YesNo

About You

2. First Name

3. Last Name

4. Gender

5. Date of Birth

6. Email

7. Phone

8. Country

9. Street Address

10. City

11. State

12. Education Level

13. Name of the institution or school

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

Your Changemaking Experience

Please tell us more about your changemaker initiative

14. Name of your Changemaker Initiative

15. When did you start this initiative?

(Please specify the month and year)

16. In what field/area is your initiative focused on?

(e. g. education / health / environment / gender, etc)

17. The Problem: Describe in detail what problem you are trying to address with your initiative?

(Explain why this problem is still around, and why solving it matters.)

18. Personal Story: What is the story behind your initiative? Why do you care about the problem you are trying to solve?

(We’re not looking for a “perfect” answer - we’d just like to learn more about you. Consider telling us about a person, place, or event that inspired you to shake things up and make a difference)

19. Your Solution: What idea have you developed to address the problem? Share your specific approach and strategies you have implemented.

20. How long have you been working on this problem?

21.Location: Where do you run the initiative?

22. Do you work with a team?

YesNo

23. How many fully committed team members do you have?

24.Team: How does your team support you in reaching your goals?

(List the roles of each team member and explain how they contribute towards the success of the initiative)

25. Impact: What level of impact have you had till date? Who are those affected by the problem that you are addressing?

(We’d love to hear both stories and numbers. Let us know how many people you’ve engaged so far)

26. You are a Changemaker… How can you help other young people become Changemakers like you?

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

28. Are there any other things you would like us to know about you and your work?

29. How did you hear about this opportunity to join Ashoka’s global network of co-leading Young Changemakers?

About You

2. First Name

3. Last Name

4. Your Email

5. Phone Number

6.How did you hear about the person you are nominating?

7.How long have you known this candidate for?

8.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?

About the Nominee

10. First Name

11. Last Name

12.City of Origin

13. Age (approximately)

14. Phone Number

This information will help us get in contact with the candidate you are nominating.

15.Preferred Email

This information will help us get in contact with the candidate you are nominating.

16.Name of the Changemaker Initiative

What is the name of the nominee's initiative/organization?

17.Tell us more about the initiative.

18.What field/area is the initiative focused on?

19.Please copy paste any link that contains stories, profile, news, or any information that helps us understand the nominee better.

20.Anything else you’d like us to know?

System Fields - NEVER EVER DELETE THESE

if you delete these fields, things will break, and you may need to rebuild your form.

dont say we didnt warn you!

System Log

Optional Fields - Required For Confirmation Email

Dotmailer Email Campaign DOTMAILER ID

NOT SFDC ID - THE DOTMAILER ID

dotmailer campaigns used for confirmation must be set as triggered campaigns, and must not contain social share / forward links (and a few other types). See here for more details.

internal note - if user wants to include response alias in dotmailer notification, we need to modify the connectors manually at present.

Optional Fields - Required If Including Opt In

Opt in via

TFA FormAshoka.orgthis sets formtype on connector to tfacomms or comms

Confirmation Form base URL

required - this form is used to complete the double opt in process.
must clone generic DOI Confirmation Form and update the URL here.
generic form : https://www.tfaforms.com/4741567

Double Opt-In Email Language

site language iso controls the language of the double opt in email. currently the text of the opt-in email cannot be altered, just the language.

Double Opt In Newsletter List

iso site country on webcontact controls which list the subscriber is added to when completing double opt in

Manual campaign mapping

REQUIRED IF XM_MANUAL SELECTED. TFA ID, MUST END IN COMMA