Ashoka Fellow Nomination Form (English)

Ashoka Fellow Nomination Form (English)

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1. Please make sure you read our selection criteria prior to submitting a nomination.

2. Are you nominating yourself?

YesNo

ABOUT YOU

First Name

Last Name

Your Email

Tell us briefly about your relationship to the nominee (and to Ashoka, if relevant)

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

YesNo

ABOUT THE NOMINEE

First Name

Last Name

Email

Phone

Country of Residence

Primary Country of Social Impact

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Ashoka is only seeking nominations in the countries listed above.

However, you may submit your nomination, and we will it on file and get in touch with you once we start operating in the countries listed below.

Other country of social impact

Additional Countries of Social Impact (Press CTRL to select multiple options)

Field of work

Target population (Press CTRL to select multiple options)

Did the nominee start an institution as the main vehicle for the idea?

YesNo

Type of Organization

Organization Name

Organization Website

Please articulate the core idea of the nominee's work and describe how this idea is new or different from current approaches.

What is the scale of the impact of the work to date?

Where can we find more information about this nominee

LinkedIn Profile

Media Links

ABOUT YOU

First Name

Last Name

Email

Phone

Country of Residence

Primary Country of Social Impact

Ashoka is only seeking nominations in the countries listed above.

However, you may submit your nomination, and we will it on file and get in touch with you once we start operating in the countries listed below.

Other country of social impact

Additional Countries of Social Impact (Press CTRL to select multiple options)

Field of work

Target population (Press CTRL to select multiple options)

Did you start an institution as the main vehicle for the idea?

YesNo

Type of Organization

Organization Name

Organization Website

Please articulate the core idea of the your work and describe how this idea is new or different from current approaches.

What is the main social problem this idea is attempting to solve? What is the impact of the problem and why does it persist?

What is the scale of the impact of your work to date?

What is your strategy for scaling the impact of your idea? What will be different in 5-10 years if you are successful?

Why are you personally dedicated to the issue? Please share relevant background, including: your history of entrepreneurship (including childhood years) and the life experiences and/or insights that led to your current path.

Links to Additional Information

LinkedIn Profile

Media Links

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

YesNo

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