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.
First Name: *
Last Name: *
Other Name (s):
Correct order of names, to appear on certificate: *
Sex: *
Required
Date of Birth: *
MM
/
DD
/
YYYY
Country of Residence: *
Nationality: *
Document Type: *
Document Number: *
City/Town or specific address: *
Email Address: *
Mobile/Cell Phone: *
Example +254 xxx xxx xxx
Current Occupation: *
Write "student" if still in school. If working, include the company/firm/organisation and present position
Current School/ College/University (if student):
Do you have any dietary/food restriction/allergy? *
If so, please describe it, including possible reactions.
Do you have any special medication you are taking? *
If so, please describe it, including possible reactions.
Do you have any disability? *
Is so, briefly describe this
Do you have membership/affiliation with other organisations? *
If so, list the organisations
Have you completed the WYA Certified Training Program? *
WYA offers the Certified Training Program (CTP). Details available: https://www.wya.net/programs/ctp/
Which WYA activities have you participated in? *
In you have not attended any WYA events, state "none".
Why do you want to attend the Africa Emerging Leaders Conference? *
What are your expectations from this conference? *
Briefly state any expectations you might have.
What is your command of English? *
The conference will be conducted in English.
How did you know about World Youth Alliance?
Would you like to be a WYA member? If Yes sign Here *
What do you understand by Human Dignity and Bio Ethics? (100 - 150 words) *
What are the current issues on Migration you are familiar with ? (100 - 150 words) *
Why is discussing livelihood important to African youth today ? (50 - 150 words) *
Why is discussing livelihood important to African youth today ? (50 - 150 words) *
How is the theme of the conference relevant to you? *
How do you intend to share what you will learn in the conference with other youth to contribute to sustainable community development? *
What other topics can you suggest for the next AELC conference? *
How do you think the Topics you have suggested above will be of impact to Emerging African Leaders? *
Submit
Never submit passwords through Google Forms.
This form was created inside of World Youth Alliance. Report Abuse