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 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.
I agree *