#MyHealthFutures Youth Network
Thank you for your interest in joining the DTH-Lab's youth network. 

Please complete the short form (less than 2mins) below to join the network. This information helps us better understand who make up the network so we can tailor opportunities to the needs/wants of the group. 

A link to join the network's LinkedIn group will be shared once you have submitted.

Website: https://dthlab.org
LinkedIn: @DTH-Lab | Group #MyHealthFutures

By providing us with your details below, you agree for your details to be stored and to be contacted by DTH-Lab regarding future events/opportunities related to the youth network.
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Name *
Surname *
Preferred email address *
Gender
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What is your date of birth? (DD.MM.YYYY)
MM
/
DD
/
YYYY
How old are you?
*
In what region are you based? (For more information on regional representation, please visit https://dthlab.org/regional-youth-champions/) *
Are you based in a low or middle income country? *
What is your country of residency? *
What is your highest level of education obtained? *
Are you currently studying? *
Which youth network(s) or organisation(s) do you represent? *
What are your areas of interest? (Tick all that apply)
If you answered other in the previous question please elaborate.
LinkedIn page
How did you hear about the #MyHealthFutures Youth Network? *
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