Registration Form: Mwanzo Program
Please answer all questions.
Email *
Name *
Date of Birth *
MM
/
DD
/
YYYY
Phone Number *
Describe yourself *
Parent/Guardian Contact *
Pastor/Sheikh Name &Number
Where do you live? With who? *
Tell us about the members of your family *
Which high school did you attend? Which year did you do KCSE? *
What grade did you attain? *
List three things you have been doing since you finished High School? *
What do you aspire to be in future? *
If you had all the money in the world, what would you do with your time? *
Who is your role model? Describe them. *
What do you do during your free time? *
Does your phone have internet access? *
How/Where did you hear about Good Kenyan? *
Required
In your opinion, who is a good Kenyan? *
What do you want to learn from the Good Kenyan Mwanzo Program? *
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms