E2 Member Nomination Your first name Your last name Your email address Nominee's first name Nominee's last name Nominee's email address Nominee’s business name(s) Nominee’s country of residence Short description of the nominee's history as a founder or entrepreneurial leader Short description of the nominee's history of social impact, through philanthropy, social entrepreneurship, or otherwise What is/are the nominee’s main field(s) of interest? Select one or more:Education & youthClimate & environmentTech & humanityEconomic developmentHealthLongevity & ageismOther: How would you describe the nominee’s vision for social change in that field/ those fields? Where can we find more about this nominee? LinkedIn Profile Media Links Check to receive news and updates from Ashoka. (Opt in) Media Consent This authorization and consent grants Ashoka, a non-profit organization based in Arlington, Virginia, (“Ashoka”, see full address below) permission to create photos, videos, and audio recordings during the event you are registering for hosted by Ashoka (the “Event”) featuring you (referred to as “Media and Recordings”) and share these Media and Recordings publicly, including to journalists, via social media, on Ashoka’s website, and/or in Ashoka publications. Ashoka’s rights under this consent extend to Ashoka’s parents, branches, subsidiaries, affiliates, agents, employees, representatives, independent contractors, and other related parties. Your authorization and consent only apply to Media and Recordings created by Ashoka during the Event. Intellectual Property You authorize Ashoka to make, modify, copy, archive, and otherwise use the Media and Recordings, free of charge, for Ashoka’s informative, promotional, and institutional purposes with or without stating your name. Your authorization allows Ashoka to use the Media and Recordings without time or location limits nor any expectation of compensation. Ashoka may publish, reproduce, modify, adapt, or share the Media and Recordings in any way, including by press, television, event websites, and websites or social profiles used for the Events. Your authorization expressly releases Ashoka from any liability for the use of your image, name, and voice, in compliance with your authorization and consent. Privacy Notice Ashoka will store and use the Media and Recordings for informative, promotional, and institutional purposes. The Media and Recordings will be processed with your consent as the legal basis for the purposes outlined above and deleted when they become irrelevant for such purposes. The recipients may include press or media organizations, non-profit organizations, Ashoka’s existing or potential members and supporters, and the public. The Media and Recordings will be transferred throughout Ashoka, which means they might be transferred to countries that do not provide the same privacy protections as your home country. You may revoke your authorization and consent at any time with an email to [email protected] or a written communication to 1700 North Moore Street, Suite 2000, Arlington, Virginia 22209-1939, United States. Your personal data will be processed in accordance with the applicable laws and regulations and Ashoka’s Privacy Policy, available at https://www.Ashoka.org/privacy-policy. Your Personal Data may be transferred to and processed in countries that do not provide the same level of data protection as your home country, as described in the Privacy Policy. By signing this document, you declare you have carefully read and evaluated this Consent form and clearly understood the meaning of each individual point before signing it. You also understand that you may end up in some Event background or group Media and Recordings even if you opt out of the form. If this concerns you, please reach out to the event staff to coordinate. You are aware that providing the authorization and consent is my free decision and that refusal to agree or later to revoke one of the following consent declarations has no negative impact on me. I hereby declare (choose one):I consent to the terms of this Event Media Authorization and Consent Form.I do not consent to the terms of this Event Media Authorization and Consent Form. Are you under 18 years oldYesNo I represent that I am a parent or legal guardian of the individual named herein, who is a minor and that the named minor has signed the Event Media Authorization and Consent. I agree that we shall both be bound by the terms of this form. Optional Additional Fields - DO NOT DELETE The fields below can be dragged up and used in your form if helpfulElse they can be left alone and will remain hidden.Do not repurpose these fields for unrelated / new purposes - create a new field instead!These fields are already 'mapped' to the corresponding fields on the campaign member in salesforce which makes everything easier and faster. Will you attend the event?YesNo Provided Org Type Provided City Provided State/Province Provided Title Provided Phone Additional Needs Dietary Restrictions Source (how you heard about event) Category (free text for ad-hoc groupings) What is your relationship with Ashoka?Ashoka FellowYoung ChangemakerPartnerAshoka StaffOther Provided Interests (can be customized) Choice AChoice BChoice Cthis maps to text 255 field on campaign member. MUST update the mapping to ensure mapped values are concise else could error. Notes 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! tfa form id (updates automatically) Required Fields - Events These fields are required IF Event Campaign TFA ID is populated. Leave Event Campaign TFA Id blank unless they need every person who responds to be added as a contact in a campaign. Cloned via Form ALLOWS US TO TRACK WHAT FORM WAS USED AS THE TEMPLATE. WHEN A NEW VERSION OF THE MASTER FORM IS CREATED, UPDATE THIS ID. Optional Fields - Events cm status calc this is a calculated field. it takes the values from the 'will you attend the event field' so that they can be used in event campaign member status mapping. this way we can update the variable values in form builder without going into the connector! if blank, default member status on campaign will be used. non ASCII characters must use the unicode values, so use \u0020 for spaces and \uu002D for hyphens. Optional Fields - Required For Confirmation Email Dotmailer Email Campaign DOTMAILER ID NOT SFDC ID - THE DOTMAILER ID OF THE EMAIL TO BE SENT WHEN THE FORM IS SUBMITTED the purpose of this field is for sending a confirmation email for an event registration or application. 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 the TFA response in the dotmailer notification, we need to modify the connectors manually at present. can use this id for testing : 2362852 Dotmailer Address Book SFDC ID (VERY RARELY USED) Required Fields - Double Opt In these fields are only required if this form will be used to collect double opt in / newsletter signup Opt in via TFA FormAshoka.orgthis sets formtype on connector to tfacomms or comms - TFA form option should very rarely be used. Ashoka.org option includes microsites. Confirmation Form base URL required for opt in via TFA Form, leave blank for dot orgthis URL is used to complete the double opt in process. must clone generic DOI Confirmation Form and set the base url to the new formgeneric doi confirmation form : https://www.tfaforms.com/4741567, Double Opt-In Email Language Please select... AR_Arabic CS_Czech DE_German EL_Greek EN_English ES_Spanish FR_French ID_Indonesian IT_Italian JA_Japanese KO_Korean NL_Dutch PL_Polish PT_Portugese RO_Romanian TH_Thai TR_Turkishsite 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 Please select... AR_Argentina AT_Austria BE_Belgium BR_Brazil CA_Canada CH_Switzerland CL_Chile CO_Colombia CS_Czech DE_Germany EG_Egypt ES_Spain FR_France GB_UK ID_Indonesia IE_Ireland IN_India IT_Italy JP_Japan KE_Kenya KR_South Korea MX_Mexico NG_Nigeria NL_Netherlands PA_Panama PH_Philippines PL_Poland PT_Portugal PY_Paraguay RO_Romania SE_Scandinavia SG_Singapore SN_Senegal TR_Turkey US_US_AshokaUpdates US_US_USNewsletter UY_Uruguay XB_US_Weekly XU_AshokaU XY_Youth Venture XZ_Youth Years XM_Manualiso 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 COMMATHIS VALUE SHOULD NEVER EVER MATCH EVENT CAMPAIGN TFA ID By submitting this form, you consent to receive communications from Ashoka.
E2 Member Nomination Your first name Your last name Your email address Nominee's first name Nominee's last name Nominee's email address Nominee’s business name(s) Nominee’s country of residence Short description of the nominee's history as a founder or entrepreneurial leader Short description of the nominee's history of social impact, through philanthropy, social entrepreneurship, or otherwise What is/are the nominee’s main field(s) of interest? Select one or more:Education & youthClimate & environmentTech & humanityEconomic developmentHealthLongevity & ageismOther: How would you describe the nominee’s vision for social change in that field/ those fields? Where can we find more about this nominee? LinkedIn Profile Media Links Check to receive news and updates from Ashoka. (Opt in) Media Consent This authorization and consent grants Ashoka, a non-profit organization based in Arlington, Virginia, (“Ashoka”, see full address below) permission to create photos, videos, and audio recordings during the event you are registering for hosted by Ashoka (the “Event”) featuring you (referred to as “Media and Recordings”) and share these Media and Recordings publicly, including to journalists, via social media, on Ashoka’s website, and/or in Ashoka publications. Ashoka’s rights under this consent extend to Ashoka’s parents, branches, subsidiaries, affiliates, agents, employees, representatives, independent contractors, and other related parties. Your authorization and consent only apply to Media and Recordings created by Ashoka during the Event. Intellectual Property You authorize Ashoka to make, modify, copy, archive, and otherwise use the Media and Recordings, free of charge, for Ashoka’s informative, promotional, and institutional purposes with or without stating your name. Your authorization allows Ashoka to use the Media and Recordings without time or location limits nor any expectation of compensation. Ashoka may publish, reproduce, modify, adapt, or share the Media and Recordings in any way, including by press, television, event websites, and websites or social profiles used for the Events. Your authorization expressly releases Ashoka from any liability for the use of your image, name, and voice, in compliance with your authorization and consent. Privacy Notice Ashoka will store and use the Media and Recordings for informative, promotional, and institutional purposes. The Media and Recordings will be processed with your consent as the legal basis for the purposes outlined above and deleted when they become irrelevant for such purposes. The recipients may include press or media organizations, non-profit organizations, Ashoka’s existing or potential members and supporters, and the public. The Media and Recordings will be transferred throughout Ashoka, which means they might be transferred to countries that do not provide the same privacy protections as your home country. You may revoke your authorization and consent at any time with an email to [email protected] or a written communication to 1700 North Moore Street, Suite 2000, Arlington, Virginia 22209-1939, United States. Your personal data will be processed in accordance with the applicable laws and regulations and Ashoka’s Privacy Policy, available at https://www.Ashoka.org/privacy-policy. Your Personal Data may be transferred to and processed in countries that do not provide the same level of data protection as your home country, as described in the Privacy Policy. By signing this document, you declare you have carefully read and evaluated this Consent form and clearly understood the meaning of each individual point before signing it. You also understand that you may end up in some Event background or group Media and Recordings even if you opt out of the form. If this concerns you, please reach out to the event staff to coordinate. You are aware that providing the authorization and consent is my free decision and that refusal to agree or later to revoke one of the following consent declarations has no negative impact on me. I hereby declare (choose one):I consent to the terms of this Event Media Authorization and Consent Form.I do not consent to the terms of this Event Media Authorization and Consent Form. Are you under 18 years oldYesNo I represent that I am a parent or legal guardian of the individual named herein, who is a minor and that the named minor has signed the Event Media Authorization and Consent. I agree that we shall both be bound by the terms of this form. Optional Additional Fields - DO NOT DELETE The fields below can be dragged up and used in your form if helpfulElse they can be left alone and will remain hidden.Do not repurpose these fields for unrelated / new purposes - create a new field instead!These fields are already 'mapped' to the corresponding fields on the campaign member in salesforce which makes everything easier and faster. Will you attend the event?YesNo Provided Org Type Provided City Provided State/Province Provided Title Provided Phone Additional Needs Dietary Restrictions Source (how you heard about event) Category (free text for ad-hoc groupings) What is your relationship with Ashoka?Ashoka FellowYoung ChangemakerPartnerAshoka StaffOther Provided Interests (can be customized) Choice AChoice BChoice Cthis maps to text 255 field on campaign member. MUST update the mapping to ensure mapped values are concise else could error. Notes 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! tfa form id (updates automatically) Required Fields - Events These fields are required IF Event Campaign TFA ID is populated. Leave Event Campaign TFA Id blank unless they need every person who responds to be added as a contact in a campaign. Cloned via Form ALLOWS US TO TRACK WHAT FORM WAS USED AS THE TEMPLATE. WHEN A NEW VERSION OF THE MASTER FORM IS CREATED, UPDATE THIS ID. Optional Fields - Events cm status calc this is a calculated field. it takes the values from the 'will you attend the event field' so that they can be used in event campaign member status mapping. this way we can update the variable values in form builder without going into the connector! if blank, default member status on campaign will be used. non ASCII characters must use the unicode values, so use \u0020 for spaces and \uu002D for hyphens. Optional Fields - Required For Confirmation Email Dotmailer Email Campaign DOTMAILER ID NOT SFDC ID - THE DOTMAILER ID OF THE EMAIL TO BE SENT WHEN THE FORM IS SUBMITTED the purpose of this field is for sending a confirmation email for an event registration or application. 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 the TFA response in the dotmailer notification, we need to modify the connectors manually at present. can use this id for testing : 2362852 Dotmailer Address Book SFDC ID (VERY RARELY USED) Required Fields - Double Opt In these fields are only required if this form will be used to collect double opt in / newsletter signup Opt in via TFA FormAshoka.orgthis sets formtype on connector to tfacomms or comms - TFA form option should very rarely be used. Ashoka.org option includes microsites. Confirmation Form base URL required for opt in via TFA Form, leave blank for dot orgthis URL is used to complete the double opt in process. must clone generic DOI Confirmation Form and set the base url to the new formgeneric doi confirmation form : https://www.tfaforms.com/4741567, Double Opt-In Email Language Please select... AR_Arabic CS_Czech DE_German EL_Greek EN_English ES_Spanish FR_French ID_Indonesian IT_Italian JA_Japanese KO_Korean NL_Dutch PL_Polish PT_Portugese RO_Romanian TH_Thai TR_Turkishsite 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 Please select... AR_Argentina AT_Austria BE_Belgium BR_Brazil CA_Canada CH_Switzerland CL_Chile CO_Colombia CS_Czech DE_Germany EG_Egypt ES_Spain FR_France GB_UK ID_Indonesia IE_Ireland IN_India IT_Italy JP_Japan KE_Kenya KR_South Korea MX_Mexico NG_Nigeria NL_Netherlands PA_Panama PH_Philippines PL_Poland PT_Portugal PY_Paraguay RO_Romania SE_Scandinavia SG_Singapore SN_Senegal TR_Turkey US_US_AshokaUpdates US_US_USNewsletter UY_Uruguay XB_US_Weekly XU_AshokaU XY_Youth Venture XZ_Youth Years XM_Manualiso 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 COMMATHIS VALUE SHOULD NEVER EVER MATCH EVENT CAMPAIGN TFA ID By submitting this form, you consent to receive communications from Ashoka.
Ashoka