PERSONAL INFORMATION:-

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DATE OF BIRTH*

GENDER*
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E-MAIL

EDUCATION & EMPLOYMENT:-

SCHOOL/INSTITUTE (IF APPLICABLE)

COURSE OF STUDY (IF APPLICABLE)

OCCUPATION*

EMPLOYER (IF APPLICABLE)

ADVOCACY INTEREST:-

Areas of interest (Please Tick all that Apply)

*

YOUTH EMPOWERMENT
EDUCATION & LITERACY
POLICY & GOVERNANCE
HUMAN RIGHTS
HEALTH & WELL BEING
ANTI-DRUG ABUSE AWARENESS
COMMUNITY DEVELOPMENT & VOLUNTEERISM

OTHERS SPECIFY

BRIEFLY DESCRIBE WHY YOU WANT TO JOIN THE YOUTH ADVOCACY COUNCIL*

SKILLS & EXPERIENCE:-

DO YOU HAVE ANY EXPERIENCE IN ADVOCACY OR COMMUNITY WORK?*
YES
NO

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WHAT SKILLS CAN YOU CONTRIBUTE TO THE COUNCIL (PLEASE TICK ALL THAT APPLY)

PUBLIC SPEAKING
EVENT PLANNING
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MEMBERSHIP COMMITTMENT:-

ARE YOU WILLING TO ATTEND MEETINGS, TRAINING & PARTICIPATE ACTIVELY?*
YES
NO

REFERENCE:-

FULL NAME*

RELATIONSHIP*

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DECLARATION:-

I certify that the information provided is true & Accurate I understand that by signing this form, I commit to Actively participating in the Youth Advocacy Council & upholding it's principles*

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YOUTH ADVOCACY COUNCIL MEMBERSHIP FORM