BECOME A MEMBER

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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 *

What is Your Registration Number *

Organization's Email Address *

Upload B: (Required)

Year of Establishment *

Category & Scope (Tick all that apply) *

Specify *

Operational Level: *

Physical/Postal/Digital Address: *

District *

Region *

Community/Town (if applicable): *

Is your organization and member-based-organization *

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 *

Full Name: *

Gender *

Position/Role in Organization: *

Email Address: *

District & Region of Residence: *

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