Universal Engagement Form

1
Enter your name to get started* This field is required.
First Name
Last Name
2
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3
I would like to* This field is required.
Tell Skoll about my COVID-19 response efforts
Tell Skoll about my organization's racial justice work
Submit a referral
Subscribe to Skoll Newsletter
Tell Skoll about my work
4
First, a few details about yourself:* This field is required.We are committed to broadening our network with new voices, diverse global leaders, and organizations actively seeking to partner around transformative social change. The following information will guide our 2020 Skoll World Forum team in understanding existing and future impactful connections. If you have any questions or issues, please contact us at registration@skoll.org.
Current Title
Organization Name
Organization Website
Please Select
Please Select
Academic Institution
Commercial Bank
Commercial Social Purpose/Social Enterprise Organization
Development Finance Bank or Institution
For-Profit Corporation
Foundation/Trust
Government/Aid Agency
Individual Investor/Donor
Investment/Asset Management
Media Company
Non-Governmental/Non-Profit Organization
Professional Services/Independent Consultants
Professional/Industry Association
N/A - None of the above
Organization Type
Please Select
Please Select
I prefer not to say
Afghanistan
Albania
Algeria
Andorra
Angola
Antigua and Barbuda
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Central African Republic (CAR)
Chad
Chile
China
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Cyprus
Czechia
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini (formerly Swaziland)
Ethiopia
Fiji
Finland
France
Gabon
Gambia
Georgia
Germany
Ghana
Greece
Grenada
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Morocco
Mozambique
Myanmar (formerly Burma)
Namibia
Nauru
Nepal
Netherlands
New Zealand
Nicaragua
Niger
Nigeria
North Korea
North Macedonia (formerly Macedonia)
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Qatar
Romania
Russia
Rwanda
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emirates (UAE)
United Kingdom (UK)
United States of America (USA)
Uruguay
Uzbekistan
Vanuatu
Vatican City (Holy See)
Venezuela
Vietnam
Yemen
Zambia
Zimbabwe
Country of Origin
Please Select
Please Select
I prefer not to say
Afghanistan
Albania
Algeria
Andorra
Angola
Antigua and Barbuda
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Central African Republic (CAR)
Chad
Chile
China
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Cyprus
Czechia
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini (formerly Swaziland)
Ethiopia
Fiji
Finland
France
Gabon
Gambia
Georgia
Germany
Ghana
Greece
Grenada
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Morocco
Mozambique
Myanmar (formerly Burma)
Namibia
Nauru
Nepal
Netherlands
New Zealand
Nicaragua
Niger
Nigeria
North Korea
North Macedonia (formerly Macedonia)
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Qatar
Romania
Russia
Rwanda
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emirates (UAE)
United Kingdom (UK)
United States of America (USA)
Uruguay
Uzbekistan
Vanuatu
Vatican City (Holy See)
Venezuela
Vietnam
Yemen
Zambia
Zimbabwe
Primary Country of Residence
Caribbean
Central America
Central and Southern Asia
Eastern and Southern Africa
Eastern Asia
Europe
Middle East and North Africa
North America
Oceania
South America
Southeast Asia
West and Central Africa
N/A - Global
Regions of Work
5
Speak at the Skoll World Forum* This field is required.To submit your name for consideration to speak at the Skoll World Forum, please let us know 2-3 sentences on what you envision. Please also include links to previous speaking engagements, if applicable.
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6
Attend the Skoll World Forum* This field is required.In 2-3 sentences, how would you contribute to the community at the Skoll World Forum?
0/4999
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7
Tell Skoll about my work* This field is required.
Please Select
Please Select
Yes
No
Do you consider yourself a Social Entrepreneur?
Why or Why Not?
Describe the mission/vision of your organization in less than 100 words
Please Select
Please Select
Economic Opportunity
Education
Environmental Sustainability
Health
Peace and Human Rights
Sustainable Markets
N/A - None of the above
Select the primary issue area of your work
8
Tell Skoll about my COVID-19 work* This field is required.
Describe the mission/vision of your organization in less than 100 words.
Please Select
Please Select
Economic Opportunity
Education
Environmental Sustainability
Health
Peace and Human Rights
Sustainable Markets
N/A - None of the above
Select the primary issue area of your work
Afghanistan
Albania
Algeria
Andorra
Angola
Antigua and Barbuda
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Central African Republic (CAR)
Chad
Chile
China
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Cyprus
Czechia
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini (formerly Swaziland)
Ethiopia
Fiji
Finland
France
Gabon
Gambia
Georgia
Germany
Ghana
Greece
Grenada
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Morocco
Mozambique
Myanmar (formerly Burma)
Namibia
Nauru
Nepal
Netherlands
New Zealand
Nicaragua
Niger
Nigeria
North Korea
North Macedonia (formerly Macedonia)
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Qatar
Romania
Russia
Rwanda
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emirates (UAE)
United Kingdom (UK)
United States of America (USA)
Uruguay
Uzbekistan
Vanuatu
Vatican City (Holy See)
Venezuela
Vietnam
Yemen
Zambia
Zimbabwe
Select the countries you are working in
Describe your COVID-19 response activities
9
Tell Skoll about my organization's racial justice work* This field is required.
Briefly describe your racial justice work in 500 words.
Afghanistan
Albania
Algeria
Andorra
Angola
Antigua and Barbuda
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Central African Republic (CAR)
Chad
Chile
China
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Cyprus
Czechia
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini (formerly Swaziland)
Ethiopia
Fiji
Finland
France
Gabon
Gambia
Georgia
Germany
Ghana
Greece
Grenada
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Morocco
Mozambique
Myanmar (formerly Burma)
Namibia
Nauru
Nepal
Netherlands
New Zealand
Nicaragua
Niger
Nigeria
North Korea
North Macedonia (formerly Macedonia)
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Qatar
Romania
Russia
Rwanda
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emirates (UAE)
United Kingdom (UK)
United States of America (USA)
Uruguay
Uzbekistan
Vanuatu
Vatican City (Holy See)
Venezuela
Vietnam
Yemen
Zambia
Zimbabwe
Select the countries you are working in
Share your thoughts on ways that Skoll can best engage in supporting racial justice work
10
Refer your network to Skoll (Individual #1)* This field is required.Please provide your referrals here for the Skoll World Forum and Skoll Award. We recommend reviewing past Awardees and current criteria on our website. I would like to refer a person to...
Be considered for a Skoll Award
Attend the Skoll World Forum
11
Details of the person you are referring (Individual #1):
First Name *
Last Name *
Email *
Organization *
Current Title
Please Select
Please Select
Academic Institution
Commercial Bank
Commercial Social Purpose/Social Enterprise Organization
Development Finance Bank or Institution
For-Profit Corporation
Foundation/Trust
Government/Aid Agency
Individual Investor/Donor
Investment/Asset Management
Media Company
Non-Governmental/Non-Profit Organization
Professional Services/Independent Consultants
Professional/Industry Association
N/A - None of the above
Organization Type
12
Refer to attend the Skoll World Forum (Individual #1)* This field is required.In 2-3 sentences, how would you envision this person contributing to the community at the Skoll World Forum?
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13
Refer to speak at the Skoll World Forum (Individual #1)* This field is required.In 2-3 sentences, why would you recommend this person to speak at the Skoll World Forum and on what topic(s)?
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14
Refer for a Skoll Award (Individual #1)* This field is required.
Please describe why you think the organization you are referring would be a good candidate for the Skoll Award:
Please Select
Please Select
Economic Opportunity
Education
Environmental Sustainability
Health
Peace and Human Rights
Sustainable Markets
N/A - None of the above
Select the primary issue area of the organization you are referring:
Caribbean
Central America
Central and Southern Asia
Eastern and Southern Africa
Eastern Asia
Europe
Middle East and North Africa
North America
Oceania
South America
Southeast Asia
West and Central Africa
N/A - Global
Please select the regions where the organization you are referring conducts its work
15
Thank you for submitting a referral. * This field is required.Would you like to refer a second person?
YESNO
16
Refer your network to Skoll (Individual #2)* This field is required.Please provide your referrals here for the Skoll World Forum and Skoll Award. We recommend reviewing past Awardees and our website for more information on our criteria. I would like to refer a second person to...
Be considered for a Skoll Award
17
Details of the person you are referring (Individual #2):
First Name *
Last Name *
Email *
Organization *
Current Title
Please Select
Please Select
Academic Institution
Commercial Bank
Commercial Social Purpose/Social Enterprise Organization
Development Finance Bank or Institution
For-Profit Corporation
Foundation/Trust
Government/Aid Agency
Individual Investor/Donor
Investment/Asset Management
Media Company
Non-Governmental/Non-Profit Organization
Professional Services/Independent Consultants
Professional/Industry Association
N/A - None of the above
Organization Type
18
Refer to attend the Skoll World Forum (Individual #2)* This field is required.In 2-3 sentences, how would you envision this person contributing to the community at the Skoll World Forum?
0/4999
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Ok
19
Refer to speak at the Skoll World Forum (Individual #2)* This field is required.In 2-3 sentences, why would you recommend this person to speak at the Skoll World Forum?
0/4999
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Small
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Ok
20
Refer for a Skoll Award (Individual #2)* This field is required.
Please describe why you think the organization you are referring would be a good candidate for the Skoll Award:
Please Select
Please Select
Economic Opportunity
Education
Environmental Sustainability
Health
Peace and Human Rights
Sustainable Markets
N/A - None of the above
Select the primary issue area of the organization you are referring:
Caribbean
Central America
Central and Southern Asia
Eastern and Southern Africa
Eastern Asia
Europe
Middle East and North Africa
North America
Oceania
South America
Southeast Asia
West and Central Africa
N/A - Global
Please select the regions where the organization you are referring conducts its work
21
Thank you for submitting a referral. * This field is required.Would you like to refer a third person?
YESNO
22
Refer your network to Skoll (Individual #3)* This field is required.Please provide your referrals here for the Skoll World Forum and Skoll Award. We recommend reviewing past Awardees and our website for more information on our criteria. I would like to refer a third person to...
Be considered for a Skoll Award
23
Details of the person you are referring (Individual #3):
First Name *
Last Name *
Email *
Organization *
Current Title
Please Select
Please Select
Academic Institution
Commercial Bank
Commercial Social Purpose/Social Enterprise Organization
Development Finance Bank or Institution
For-Profit Corporation
Foundation/Trust
Government/Aid Agency
Individual Investor/Donor
Investment/Asset Management
Media Company
Non-Governmental/Non-Profit Organization
Professional Services/Independent Consultants
Professional/Industry Association
N/A - None of the above
Organization Type
24
Refer to attend the Skoll World Forum (Individual #3)* This field is required.In 2-3 sentences, how would you envision this person contributing to the community at the Skoll World Forum?
0/200
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Refer to speak at the Skoll World Forum (Individual #3)* This field is required.In 2-3 sentences, why would you recommend this person to speak at the Skoll World Forum?
0/4999
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Small
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Ok
26
Refer for a Skoll Award (Individual #3)* This field is required.
Please describe why you think the organization you are referring would be a good candidate for the Skoll Award:
Please Select
Please Select
Economic Opportunity
Education
Environmental Sustainability
Health
Peace and Human Rights
Sustainable Markets
N/A - None of the above
Select the primary issue area of the organization you are referring:
Caribbean
Central America
Central and Southern Asia
Eastern and Southern Africa
Eastern Asia
Europe
Middle East and North Africa
North America
Oceania
South America
Southeast Asia
West and Central Africa
N/A - Global
Please select the regions where the organization you are referring conducts its work
27
Thank you for submitting a referral.* This field is required.Would you like to refer a fourth person?
YESNO
28
Refer your network to Skoll (Individual #4)* This field is required.Please provide your referrals here for the Skoll World Forum and Skoll Award. We recommend reviewing past Awardees and our website for more information on our criteria. I would like to refer a fourth person to...
Be considered for a Skoll Award
29
Details of the person you are referring (Individual #4):
First Name *
Last Name *
Email *
Organization *
Current Title
Please Select
Please Select
Academic Institution
Commercial Bank
Commercial Social Purpose/Social Enterprise Organization
Development Finance Bank or Institution
For-Profit Corporation
Foundation/Trust
Government/Aid Agency
Individual Investor/Donor
Investment/Asset Management
Media Company
Non-Governmental/Non-Profit Organization
Professional Services/Independent Consultants
Professional/Industry Association
N/A - None of the above
Organization Type
30
Refer to attend the Skoll World Forum (Individual #4)* This field is required.In 2-3 sentences, how would you envision this person contributing to the community at the Skoll World Forum?
0/4999
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31
Refer to speak at the Skoll World Forum (Individual #4)* This field is required.In 2-3 sentences, why would you recommend this person to speak at the Skoll World Forum?
0/4999
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Small
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Ok
32
Refer for a Skoll Award (Individual #4)* This field is required.
Please describe why you think the organization you are referring would be a good candidate for the Skoll Award:
Please Select
Please Select
Economic Opportunity
Education
Environmental Sustainability
Health
Peace and Human Rights
Sustainable Markets
N/A - None of the above
Select the primary issue area of the organization you are referring:
Caribbean
Central America
Central and Southern Asia
Eastern and Southern Africa
Eastern Asia
Europe
Middle East and North Africa
North America
Oceania
South America
Southeast Asia
West and Central Africa
N/A - Global
Please select the regions where the organization you are referring conducts its work
33
Thank you for submitting a referral.* This field is required.Would you like to refer a fifth person?
YESNO
34
Refer your network to Skoll (Individual #5)* This field is required.Please provide your referrals here for the Skoll World Forum and Skoll Award. We recommend reviewing past Awardees and our website for more information on our criteria. I would like to refer a fifth person to...
Be considered for a Skoll Award
35
Details of the person you are referring (Individual #5):
First Name *
Last Name *
Email *
Organization *
Current Title
Please Select
Please Select
Academic Institution
Commercial Bank
Commercial Social Purpose/Social Enterprise Organization
Development Finance Bank or Institution
For-Profit Corporation
Foundation/Trust
Government/Aid Agency
Individual Investor/Donor
Investment/Asset Management
Media Company
Non-Governmental/Non-Profit Organization
Professional Services/Independent Consultants
Professional/Industry Association
N/A - None of the above
Organization Type
36
Refer to attend the Skoll World Forum (Individual #5)* This field is required.In 2-3 sentences, how would you envision this person contributing to the community at the Skoll World Forum?
0/4999
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Small
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Ok
37
Refer to speak at the Skoll World Forum (Individual #5)* This field is required.In 2-3 sentences, why would you recommend this person to speak at the Skoll World Forum?
0/4999
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Large
Normal
Small
Ok
Ok
38
Refer for a Skoll Award (Individual #5)* This field is required.
Please describe why you think the organization you are referring would be a good candidate for the Skoll Award:
Please Select
Please Select
Economic Opportunity
Education
Environmental Sustainability
Health
Peace and Human Rights
Sustainable Markets
N/A - None of the above
Select the primary issue area of the organization you are referring:
Caribbean
Central America
Central and Southern Asia
Eastern and Southern Africa
Eastern Asia
Europe
Middle East and North Africa
North America
Oceania
South America
Southeast Asia
West and Central Africa
N/A - Global
Please select the regions where the organization you are referring conducts its work
39
Thank you for providing referrals for the Skoll Foundation network! Where appropriate, we will reach out to the individual or organization directly to learn more.
Should be Empty: