Social Innovation to Tackle Energy Poverty 2019 - Application Form

Social Innovation to Tackle Energy Poverty 2019 - Application Form


1. The person who will be participating in the program.

Organization: If your organization focuses solely on the topic of energy poverty, the applicant should be the founder, co-founder, director, or senior manager of the organization. If your organization has a broader scope, the applicant should be the project manager for or leader of the project relevant to the topic of energy poverty.
3. Your organization (if relevant)

Organization: If your organization focuses solely on the topic of energy poverty, please consider the word “project” as synonym of “organization.” If, however, your organization has a broader scope, please answer the questions with information relevant to the project on energy poverty.
This description will be used for our internal and external communication, so please be as specific and clear as possible and include the main activities of your project/organization.
Please include key statistics and measurements about the social issue(s) you are describing.
Please describe how the idea is addressing root causes of the problem.

Please identify and quantify your direct and indirect target audience. Please describe to what extent the beneficiaries are/will be included in the planning and implementation of the project.
Please include both qualitative and quantitative indicators including the number of beneficiaries. Please describe the impact that the project will have on the quality of human life.
Please describe the responsibilities that you have within the project and how do you contribute to achieve the project’s impact.
Please include a breakdown of income, e.g. 50% from sales of product/services, 20% from public funds (government departments, local authorities), 10% from private companies, 10% from international institutions/organizations, 5% from corporate foundations, and 5% from private donations/subscriptions. You may also upload an Excel spreadsheet to support your answer.


Relevant information may include a video of you pitching your project, infographics to describe your solution, etc.

Relevant information may include a video of you pitching your project, infographics to describe your solution, etc.







The information and the documents provided will help Ashoka verify the organization’s compliance with the Social Innovation to Tackle Energy Poverty Program’s T&Cs. It is essential that the information provided is detailed, complete, and truthful.

Statement

  • The Organization: Fills this application within the framework of the Social Innovation to Tackle Energy Poverty program;
  • Commits to participating in the Social Innovation to Tackle Energy Poverty program in its entirety and to be present – or mandate one or two members of the management team – to all the gatherings held within the framework of the program; and
  • States that it has acknowledged the Regulation of the Social Innovation to Tackle Energy Poverty program (“the Regulation”) and accepts, without reserves nor conditions, the entirety of the terms and conditions of the Regulation.
Without prejudice to provisions of the Regulation, acknowledges and accepts in particular that:
  • The decisions regarding the applicants’ selection are taken by the Regional Selection Committee that includes Ashoka’s representatives and experts with experience in the social entrepreneurship sector. The decision is final and applies to all candidates;
  • All the documents and materials provided by the Organization will not be sent back to the Organization. Ashoka has the right to keep or destroy these files and materials without any possibility to appeal from the Organization; and
  • Ashoka will be authorized to record, transfer, and process all personal data received from the Organization during and after the application process in the context of the Social Innovation to Tackle Energy Poverty program.
Without prejudice to provisions of the Regulation, in case a prize is granted, commits in particular to:
  • Authorizing Ashoka to undertake an enquiry, to the extend Ashoka finds helpful, in order to verify the compliance between the Organization and the information provided by the Organization in the written application form or orally;
  • Participating in all the steps of the mentoring program. In the event it does not, the Organization could be disqualified without any possibility to appeal; 
  • Ensuring a follow-up regarding the development of the project and participating in a best-practice sharing mindset;
  • Authorizing Ashoka, without any financial compensation nor conditions, to (i) communicate the Social Innovation to Tackle Energy Poverty program’s results to a third party, in particular media and/or partners, (ii) communicate their personal details to the media, provided that the Organization was informed before, (iii) use, publish, and broadcast for the needs of the Social Innovation to Tackle Energy Poverty program, their distinctive sign(s) as well as the characteristic elements of their project on any support and by any means chosen, and (iv) use, publish, and broadcast their activity and their development model and/or their resources mobilization description in a best-practice report that will be produced at the end of the Social Innovation to Tackle Energy Poverty program; and
  • Making sure that all the people involved in the Organization are properly informed about the terms and conditions in the “Regulation” and in this “Statement” and are accepting them without any reservation nor condition.
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