UPSHIFT APPLICATION FORM
UPSHIFT: Social Impact Workshop helps marginalized adolescents and youth become social innovators and entrepreneurs by providing experiential learning in understanding community challenges and designing and building solutions in the form of products or services, and starting and leading the ventures that deliver them.
ELIGIBILITY
Your team must have five (5) members in total, including you;
Every member of your team must be between the ages of 15 and 24;
Every member of your team must be citizen of Prishtina, Fushë Kosovo, Obiliq, Podujeva, Drenas, Novobërda, and Graçanica
Every team member must be present during the entire workshop on
February 21, 22, and 23, 2020. Application deadline: Wednesday, February 12, 2020 TIP
Choose teammates with a mix of interests and skills—your team is better off with different types of thinkers!
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BUILD YOUR TEAM
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Please provide the required information about your team members.
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TEAM MEMBER 1 Information
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First Name
*
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Last Name
*
5
Date of Birth
*
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*
Gender
Female
Male
Trans
I prefer not to disclose
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*
Ethnicity
Albanian
Serbian
Bosnian
Turkish
Roma
Egyptian
Ashkali
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Town/Village/City
*
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Phone
*
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Email
*
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TEAM MEMBER 2 Information
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First Name
*
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Last Name
*
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Date of Birth
*
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*
Gender
Female
Male
Trans
I prefer not to disclose
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*
Ethnicity
Albanian
Serbian
Bosnian
Turkish
Roma
Egyptian
Ashkali
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Town/Village/City
*
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Phone
*
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Email
*
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TEAM MEMBER 3 Information
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First Name
*
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Last Name
*
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Date of Birth
*
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*
Gender
Female
Male
Trans
I prefer not to disclose
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Country
*
select your country
Ethnicity
Albanian
Serbian
Bosnian
Turkish
Roma
Egyptian
Ashkali
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Town/Village/City
*
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Email
*
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Phone
*
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TEAM MEMBER 4 Information
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First Name
*
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Last Name
*
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Date of Birth
*
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*
Gender
Female
Male
Trans
I prefer not to disclose
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Country
*
select your country
Ethnicity
Albanian
Serbian
Bosnian
Turkish
Roma
Egyptian
Ashkali
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Town/Village/City
*
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Phone
*
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Email
*
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TEAM MEMBER 5 Information
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Emri
*
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Mbiemri
*
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Date of birth
*
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*
Gender
Female
Male
Trans
I prefer not to disclose
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*
Ethnicity
Albanian
Serbian
Bosnian
Turkish
Roma
Egyptian
Ashkali
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Town/Village/City
*
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Phone
*
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Email
*
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CHALLENGE DESCRIPTION
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What bothers or frustrates you in your community? Please identify a specific challenge for which your team is eager to find solutions.
TIPS
Try taking 20 minutes with your whole team to come up with as many challenges as possible before narrowing down to one.
It’s better to think of something small and specific, rather than big and general. Think specifically and concretely about challenges that impact people’s daily lives!
A challenge can usually be stated in 1-3 sentences.
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What bothered or frustrated you recently in your community, city, village, school or neighborhood?
*
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CAUSES OF THIS CHALLENGE
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As a team, think of 3 possible causes of the challenge that you have identified.
TIPS
To determine a cause, think one step backward from the challenge by asking, “Why did this challenge occur?” and “What actions, attitudes, or existing conditions led or resulted in the challenge?”
A cause can usually be stated in 1 word or sentence.
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Cause 1
*
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Cause 2
*
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Cause 3
*
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PEOPLE IMPACTED BY THIS CHALLENGE
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We are looking for other people that are impacted by this challenge!
Who are the people who face this challenge?
TIPS
We ask you to find other persons that are affected by this challenge, in case it is just you, try to find another challenge, because we are trying to solve community challenges.
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People impacted 1
*
full name
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People impacted 2
*
full name
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People impacted 3
*
full name
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CHALLENGE IMPORTANCE
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Why do you think it's important to solve this challenge? Please list three main reasons.
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Reason 1
*
full name
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Reason 2
*
full name
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Reason 3
*
full name
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Have you ever participated in any of the UNICEF Innovations Lab Kosovo workshops?
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yes/no
*
select your country
Yes
No
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Which workshop?
*
UPSHIFT: Social Impact Workshop
PONDER: Critical Media Literacy
PODIUM: Advocacy for Change
Kosovo Volunteers
Know Your Rights
STARTUP: Social Venture Workshop
TECHSTITUTION
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Did you benefit from the project/campaign implementation, internship programme, or Volunteering experience?
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YES/NO
*
Yes
No
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SUBMIT
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