APPLICATION FORM Activista Nigeria Organising for Change Training 16-21 April 2012 Name Date of Birth Sex Address Where are you based in Nigeria? Email Telephone Number Educational Qualification (Most recent) Please give an apt description of yourself, your motivation, vision, and fears (Maximum 200 Words) Why do you want to participate in this training? (Maximum 200 words) Have you been or currently involved in Youth activism? (Please give a background) (Maximum 150 Words) Looking at the profile of the training, How relevant is it to you at a personal level and at a group level (if you belong to a (Maximum 150 Words)
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APPLICATION FORM
Activista Nigeria Organising for Change Training16-21 April 2012
Name
Date of Birth
Sex
Address
Where are you based in Nigeria?
Telephone Number
Educational Qualification (Most recent)
Please give an apt description of yourself, your motivation, vision, and fears
(Maximum 200 Words)
Why do you want to participate in this training?
(Maximum 200 words)
Have you been or currently involved in Youth activism?(Please give a background)
(Maximum 150 Words)
Looking at the profile of the training, How relevant is it to you at a personal level and at a group level (if you belong to a group)?
(Maximum 150 Words)
What would you do with the skills from the training?
(Maximum 200 words)
What would be your plans for expanding the Activista network in your locality?
(Maximum 200 words)
Completed forms should be sent to [email protected] not later than 9th April 2012.
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