REGISTRATION FORM

VIRTUAL SUMMIT OF YOUNG LEADERS AND ACTORS OF LOCAL DEVELOPMENT IN AFRICA

"African youth, empowerment, security and citizens’ responsibilities": major challenges, difficulties encountered and possible solutions September 07 to 10, 2021 REGISTRATION FORM TO PARTICIPATE IN THE SUMMIT

INSCRIPTION

First Name: *
Last Name: *
Age: *
Sex: * M.F.
Organisation (optionel):
Country: *
City: *
Téléphone/mobile: *
Email: *
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 2 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 2 months before the Summit.

Attach a copy of your passport or national identity card*

Attach your CV*

Attach your photo (passport size) *

Note : Note: Confirmation and invitations will be sent to participants in time to allow them to prepare.

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.
photo.

I agree *

* Mandatory .

Email : contact@pcyaaf.org
Facebook : https://www.facebook.com/pcyaaf/
Twitter : https://twitter.com/PcyaAf

CONTACT US

REGISTRATION FORM

VIRTUAL SUMMIT OF YOUNG LEADERS AND ACTORS OF LOCAL DEVELOPMENT IN AFRICA