First Name: *
Last Name: *
Sex: * M. F.
Why do you want to participate in this summit? - in 10 lines maximum*
Please explain to us in 10 lines maximum your strategy to open a PCYA-AF branch in your country in less than 5 months before your participation in the summit (before completing this section, we recommend that you consult the information relating on the opening of PCYA-AF branches on our website in the section REPRESENT US, Ref. http://pcyaaf.org/ )*
Note that if your application is successful, you agree to launch a COPAJE-AF branch in your country no later than 5 months before the Summit.
Attach a copy of your passport or national identity card*
Attach your CV*
Attach your photo (passport size) *
Note : Note: The stay (accommodation, catering and hotel / hostel-airport transport) of the selected participants is the responsibility of the organizers from September 6th to 11th, 2021. International transport (from the country of origin to Ouagadougou) is the responsibility of the participants. Confirmation and invitations will be sent to participants in time to allow them to prepare and if necessary to find sponsors for their trip.
By sending my application, I authorize PCYA-AF to collect and process my personal information for the purposes of participating in the Summit of Young Leaders and Local Development Actors in Africa.
I understand that the information, referred to as “personal data”, include, but is limited to my name, address, phone number, email address and photo.
I agree *