Alumni Registration Form
Salutation *
First Name *
Last Name *
Gender *
Required
Email Address *
Would you like to subscribe for Alumni email newsletter? *
Required
ID Number
Mobile Number *
Address - Street *
City *
State/Province *
Zip/Postal Code *
Country *
What is your ethnicity? *
Which programmes did you take part in or access while you were at Afrika Tikkun? *
Which centre did you attend? *
Required
What year did you graduate from Afrika Tikkun? *
Required
What is your highest qualification? *
Required
What is your current employment status? *
Required
If you are working or studying, what is the name of the company or university/ college?
How would you like to stay connect to Afrika Tikkun?
Submit
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