2021 Ashoka U Exchange Scholarship Application
We are excited to offer a scholarship opportunity for those who need assistance with costs related to the 2021 Ashoka U Exchange. With a limited number to offer we ask for your consideration in thoroughly assessing your need. It is our intention that these scholarships aid our community members to the best extent possible, which is why we will be offering partial and full scholarships.
Background Information
Preferred First Name
Please use the name that you have used or intend to use for the Exchange Registration and/or Application form.
Preferred Last Name
Email Address
Organization
Organization Type. Check all that apply.
Private Institution
Non-Profit Organization
Public / State University
Community-Based
Organization*
Historically Black College or University
Government
Community College
K-12 School
Women's College
For-Profit Organization
Other
*Select Community-Based Organization if your organization places your local community's social health, well-being, and overall functioning at the center of its impact.
Other (organization type)
Country
Please select...
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos ( Keeling ) Islands
Colombia
Comoros
Congo
Congo ( DRC )
Cook Islands
Costa Rica
Côte d ' Ivoire
Croatia ( Hrvatska )
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Faroe Islands
Fiji Islands
Finland
France
French Guiana
French Polynesia
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong SAR
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Korea
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao SAR
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Reunion
Romania
Russia
Rwanda
Samoa
San Marino
São Tomé and Prìncipe
Saudi Arabia
Senegal
Serbia and Montenegro
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
Spain
Sri Lanka
St. Helena
St. Kitts and Nevis
St. Lucia
St. Pierre and Miquelon
St. Vincent and the Grenadines
Sudan
Suriname
Svalbard and Jan Mayen
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Viet Nam
Virgin Islands
Virgin Islands ( British )
Wallis and Futuna
Yemen
Zambia
Zimbabwe
Please select the country of your organization / university
Please indicate which best describes your role. Check all that apply.
Undergraduate Student
Ashoka Fellow
Graduate Student
Non-Profit Professional
Staff
Community Partner*
Faculty
Government Employee
Senior Administrator**
For-Profit Professional
K-12 Educator
Other
*Select Community Partner if you are embedded directly in the community and your impact is most felt on your community's social health, well-being, and overall functioning.
**Select Senior Administrator if you are Dean-level or above.
Other (role)
Role title
Have you attended the Exchange before?
Yes
No
How will attending the Exchange influence your changemaker journey?
Demographic Information
In partnership with the
Exchange Councils
we've crafted these questions to help paint a more complete picture about our community. They will be used only in the context of better understanding your individual identity and lived experience.
These questions are optional, and you will not be penalized if you don't answer. Under no circumstance will we share individual information beyond the Ashoka U team during the submission review process. We appreciate your openness and willingness to share.
Which range below indicates your age:
Under 18
18 - 23
24 - 34
35 - 44
45 - 54
55 - 64
65+
Which of the following describes your racial/ethnic background (check all that apply):
Afro-Caribbean
Asian
Black/African American/African
Hispanic/Latinx
Middle Eastern
Multiracial/Bi-racial/Mixed Race
Native American/Indigenous/Alaska Native/First Nations/Aboriginal/ Inuit/ Matee
Native Hawaiian/Asian Pacific Islander
Non-Hispanic White/Caucasian/Euro-American
South Asian
Other
Inuit
Matee
Please specify:
Ability status (e.g. not living with a disability, deaf, living with ADHD, etc for Exchange accommodations):
Scholarship Needs
I am interested in receiving a:
Partial community scholarship
Full community scholarship
Please share some context about your need (150 words):
Privacy and Ashoka U Engagement
I agree to sharing the information in this form with the Ashoka U team and Exchange Councils.
Yes
No
Check this box to receive future communications from Ashoka U:
OptInValue (DO NOT DELETE ME IM HIDDEN)
this is used for the skip logic in the connector, bc its a PITA
By submitting this form, you acknowledge that your Personal Data will be processed outside the EEA as described in the
Privacy Policy
.
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