2022 Changemaker Education Research Forum 

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We look forward to welcoming you to the 2022 Changemaker Education Research Forum (CERF), taking place in-person in Halifax, Nova Scotia and online on September 17 - 18, 2022.

Unless you select otherwise below, your information will remain private for our internal use, and we will remove any information upon your request.  If you have any questions, concerns, or issues, please contact us at researchforum@ashoka.org.       

NOTE: If you have registered for ISIRC and would like to attend CERF in person, please email us at researchforum@ashoka.org and we will send you a discount code.
Section 1: Level of Engagement
Section 2: Registrant Details
In English, pronouns are used to refer to someone in the 3rd person and imply gender. We ask for your pronouns because we aim to respect your personal identity and make our environment more welcoming
text: https://twitter.com/yourhandle
*Please note that if you select "No", you will not be listed in our Attendee Directory.
Ashoka Updates
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.  
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
doi is hard coded in the connectors
By submitting this form, you consent to receive communications from Ashoka.
Attendee Experience
Media Consent

The following authorization and consent grants Ashoka, a non-profit organization based in Arlington, Virginia, (“Ashoka”, see full address below) permission to take photos and make video and audio recordings at the event you are registering for hosted by Ashoka (the “Event”) featuring you (collectively, the “Media Records”) and use such Media Records for public relations purposes of Ashoka as outlined below. 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 privacy@ashoka.org 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.

I am 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.

Funding for scholarships
We are committed to make this event as accessible as possible. In order to do so, we will be offering scholarships to participants from underserved communities in need.
Payment Amount
Pay as you want: Ashoka Canada is a non-profit organization that promotes social innovation and changemaking to build a more resilient, inclusive, and equitable future.   

The Forum’s online content is free and available to anyone who would like to watch. If you would like to make a voluntary contribution to support our work, please pay here as you wish.  Thank you for your time and support!  

If you wish to contribute, please type here the amount you would like to donate ($CAD)
Payment Information
Refund Policy
Ashoka U will provide a full refund through August 15, 2022. To request a refund please reach out to researchforum@ashoka.org