Africa Emerging Leaders Conference 2018, Application Form
Dear Youth Leader,
Kindly fill out this form correctly. Your entries will be subject to evaluation by a selection team.
The conference is open to participants 16-35 years. The conference fee is KES 3,500 or USD 35
WYA Africa Team.
* Required
First Name:
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Your answer
Last Name:
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Your answer
Other Name (s):
Your answer
Correct order of names, to appear on certificate:
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Your answer
Sex:
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Male
Female
Required
Date of Birth:
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MM
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DD
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YYYY
Country of Residence:
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Your answer
Nationality:
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Your answer
Document Type:
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Passport
National ID
School ID
Document Number:
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Your answer
City/Town or specific address:
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Your answer
Email Address:
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Your answer
Mobile/Cell Phone:
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Example +254 xxx xxx xxx
Your answer
Current Occupation:
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Write "student" if still in school. If working, include the company/firm/organisation and present position
Your answer
Current School/ College/University (if student):
Your answer
Do you have any dietary/food restriction/allergy?
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If so, please describe it, including possible reactions.
Your answer
Do you have any special medication you are taking?
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If so, please describe it, including possible reactions.
Your answer
Do you have any disability?
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Is so, briefly describe this
Your answer
Do you have membership/affiliation with other organisations?
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If so, list the organisations
Your answer
Have you completed the WYA Certified Training Program?
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WYA offers the Certified Training Program (CTP). Details available:
https://www.wya.net/programs/ctp/
Y
N
Which WYA activities have you participated in?
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In you have not attended any WYA events, state "none".
Your answer
Why do you want to attend the Africa Emerging Leaders Conference?
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Your answer
What are your expectations from this conference?
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Briefly state any expectations you might have.
Your answer
What is your command of English?
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The conference will be conducted in English.
Mother Tongue
Fluent
Good
Average
Satisfactory
How did you know about World Youth Alliance?
Your answer
Would you like to be a WYA member? If Yes sign Here
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Yes
No
What do you understand by Human Dignity and Bio Ethics? (100 - 150 words)
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Your answer
What are the current issues on Migration you are familiar with ? (100 - 150 words)
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Your answer
Why is discussing livelihood important to African youth today ? (50 - 150 words)
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Your answer
Why is discussing livelihood important to African youth today ? (50 - 150 words)
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Your answer
How is the theme of the conference relevant to you?
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Your answer
How do you intend to share what you will learn in the conference with other youth to contribute to sustainable community development?
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Your answer
What other topics can you suggest for the next AELC conference?
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Your answer
How do you think the Topics you have suggested above will be of impact to Emerging African Leaders?
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Your answer
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