2019 Ashoka U Exchange Registration

Select Your Ticket

Please submit your registration to confirm your attendance at the 2019 Exchange. Please note only individuals can register here. Please contact Luciana Goles, lgoles@ashoka.org, to inquire about group registration.

By filling out this form you’re granting us permission to share your information with other participants of the conference for networking and content purposes.

*On this form you must pay via credit or debit card. If you would like use another form of payment for your Exchange ticket, please contact Luciana Goles, lgoles@ashoka.org. 

**Ashoka U will provide a full refund until December 15, 2018. A 50% refund will be offered from December 16, 2018 to January 15, 2019.

Please select the ticket you'd like to purchase

$999 - Registration $699 - Student Registration (Limited Availability)Please note you can only purchase one ticket at a time. For group purchases contact lgoles@ashoka.org.

Promo Code

Ticket Price (USD)

Registrant Details

Please enter your information below

First Name

Last Name

Pronouns

Pronouns are used as a way to identify or refer to someone's gender identity.

Other Pronouns

Role

Other Role

Role title

This is subject to appear in the agenda and/or attendee directory.

Organization

Country

Canada Day

Canada Day will take place the day before the Exchange, Wednesday, February 20. Please click below if you would like more information on this event.

Please send me information about Canada Day

Día de Latinoamérica

El día de Latinoamérica se llevará a cabo el día anterior al Exchange, el miércoles 20 de Febrero, 2019. Haga clic a continuación si desea obtener más información sobre este evento.

Quiero recibir mas informacion sobre el día de Latinoamérica.

Organization Type

Community College	Historically Black College or University
K-12 School	Liberal Arts College
Private Institution	Private-Sector Organization
Public/State Institution	Social-Sector Organization
Women's College	Other

Check all that apply.

Discipline Type

Have you attended the Exchange before?

YesNo

Would you like to be placed in a Peer Huddle group? Peer Huddles are groups of 8-10 participants that meet 2-3 times throughout the Exchange to check-in and debrief.

YesNoLimited space available on a first come first serve basis.

Senior Leaders Experience

The "Senior Leaders' Experience" is a 1.5 day experience that runs parallel to the Exchange and goes all day Thursday, February 21st, and Friday, February 22nd through 11:30am. Questions? Contact Nimesh Ghimire, nghimire@ashoka.org.

Please check here if you are planning to attend the Senior Leaders' Experience.

Open to any university leader Dean-level and above attending the Exchange, the Senior Leaders’ Experience offers networking and learning alongside Senior Leader peers. Also included is flexible content on key strategy issues relevant to college and university leaders.

How did you find out about the Exchange?

Other Source

Please rate the following on a scale of 0 to 10, with 10 representing your ideal level.

Your connection to a social innovation community across higher education

Your level of comfort explaining social innovation and/or changemaking to others.

Your level of comfort identifying as a driver of change.

Your level of confidence in advancing social innovation and/or changemaking efforts at your institution.

Billing

Please note you must pay via credit or debit card. If you would like use another form of payment for your Exchange ticket, please contact Luciana Goles, lgoles@ashoka.org.

À La Carte Items

We invite you to purchase any additional Ashoka U offerings, including knowledge resources and Exchange marketing opportunities.

Ashoka U Knowledge Resources. Click here to learn more

$12.00 - Changemaker Institutions $69.00 (PRE-ORDER) (Reg $139) Preparing Students for a Rapidly Changing World: Learning Outcomes for Social Innovation, Social Entrepreneurship, and Changemaking Education

Exchange Marketing Opportunities. Want to get the word out about your program at the Exchange? Please select the opportunity you'd like to purchase and we'll be in touch with more details.

$250 - Quarter-page advertisement in the Exchange printed program $500 - Half-page advertisement in the Exchange printed program $1000 - Full-page advertisement in Exchange printed program$450 - Marketplace vendor booth at the Exchange (Non-Profit and University Rate)$650 - Marketplace vendor booth at the Exchange (For-profit Rate)

Have questions? Go to www.ashokau.org/exchange

Payment Amount

Ticket Price

A La Carte Items

Shipping Cost

$5 - Domestic $15 - International

Total Price for Payment ($ USD)

Payment Information

Name on Card

Card Number

Security Code

Shipping Address

Street Address

Address Line 2

City

State / Province / Region

Postal Zip Code

Country

Additional Information

Can the biographical information provided in this form be shared with conference participants

Yes Yes - everything EXCEPT my email address No

Please provide information about your food needs and preferences (OPTIONAL)

Vegetarian Vegan Gluten-Free Kosher Nut Allergy

Please share any additional needs you may have for the Exchange. Please be as specific as possible (ex. wheelchair access, sign language interpreters, etc)

All requests must be submitted by December 20, 2018 for the Exchange team to accommodate

Ashoka U events are videotaped and photographed. By attending, you hereby irrevocably grant to Ashoka the right to photograph your image & record your voice & to use it in programming & advertisements. If you do not agree, steer clear of areas where filming occurs.

I agree!

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