CHANGEMAKERS DIALOGUE! | Application Form 2021/2022

Changemaker Dialogues! is a course of 6 online gatherings to connect, strengthen and unlock the potential of the European community of changemakers in education​. This course is free of charge. 

IMPORTANT: Please send one application form per participant. If you want to bring more people from your team or other partners, please make sure they fill out a separate application as well. Thank you!

Optional Additional Fields - DO NOT DELETE
The fields below can be dragged up and used in your form if helpful

Else 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.  

this maps to text 255 field on campaign member. MUST update the mapping to ensure mapped values are concise else could error.
if you delete these fields, things will break, and you may need to rebuild your form. 

dont say we didnt warn you!
Required Fields
this value is used in event campaign member status mapping. we can update the variable values in build - do not need to go into the connector anymore!  use \u0020 for spaces
Optional Fields - Required For Confirmation Email
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 in dotmailer notification, we need to modify the connectors manually at present.  can use this email address book id for testing : 2362852
Optional Fields - Required If Including Opt In
this sets formtype on connector to tfacomms or comms
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 :
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.
iso site country on webcontact controls which list the subscriber is added to when completing double opt in
By submitting this form, you consent to receive communications from Ashoka.
Ashoka envisions a world free of systemic oppression in which each individual has access to resources, voice, power and safety. We are committed to building a community that represents a variety of backgrounds, identities and perspectives. We encourage people who are personally affected by structural/systemic discrimination to apply.  

This is why we are asking you to answer the following questions. Your self-identifying answers will help us better understand the community that our organization is attracting, and it will inform us in our evolution to become a fully diverse, equitable, and inclusive organization. 

The questions are optional and none of the information below will have any impact on your application process. The information you provide below will be anonymized and only used and analyzed in collaboration with our Diversity, Equity, and Inclusion team. 

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 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

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.