BECOME A MEMBER

Please enable JavaScript in your browser to complete this form.

Please note: Registration with the National Youth Authority (NYA) is mandatory for all applicant groups.

Part A: Organization Information

& A: your

Registration Number with National Youth Authority (Required) *

Full Name of Youth Group/Organization *

About Your Organization *

Briefly describe your organization’s mission, main activities, and target beneficiaries (Max. 200 words):

Is your organization Registered with Registrar of Companies *

Yes
No

What is Your Registration Number *

Organization's Email Address *

Organization's Phone Number *

Organizations Website/Active Social Media link

Year of Establishment *

Category & Scope (Tick all that apply) *

Youth-Led
Youth-Serving (Youth-focused)
Student Group
Faith-Based Youth Organization
NGO
Other (Specify):

Specify *

Operational Level: *

Physical/Postal/Digital Address: *

District *

Region *

Community/Town (if applicable): *

Is your organization and member-based-organization *

Yes
No

Total Number of Members: *

N# of Female Members *

N# of Male Members: *

N# of Members with Disabilities (PWDs) *

N# of Members between 18–24 years: *

N# of Members between 25–35 years: *

N# of Members 36+ years *

List of Key Executives/Directors (Name, Role, Gender, Contact) *

Programmes & Focus Areas *

Entrepreneurship & Employment
Education & Skills Development
Gender & Inclusion
Civic Engagement & Governance
Climate & Environment
Arts, Sports & Culture
Health and Wellbeing
Other (Specify)

Upload NYA Registration Certificate (Required) *

Click or drag a file to this area to upload.

Upload Constitution (Optional) *

Click or drag a file to this area to upload.

Upload ORC Certificate *

Click or drag a file to this area to upload.

Part B: Contact Person (Representative) Information

Full Name: *

Gender *

Female
Male

Position/Role in Organization: *

Phone Number: *

Email Address: *

District & Region of Residence: *

Scroll to Top