NAELE VOICE OF AFRICA GROUP REGISTRATION FORM

PERSONAL INFORMATION

First Name       ________________________

Middle Name ________________________

Sir. Name       _________________________

Sex        ____________________

Maritual Status _________________________

Family Standard _________________________

Level of Education _______________________

Your body ability ___________________________

Street  _________________________________

Ward ___________________________________

District _________________________________

Region ___________________________________

Country __________________________________

Nationality _________________________________

Preffered Tel/Cell _________________________________________ (Please remember to put your country code)

Preffered Email  __________________________________________

Postal Adress ____________________________________________

WORK INFORMATION

Occupation ____________________________________

Title          _____________________________________

Organisation   _______________________________________

PERFOMANCE AND PERSONAL STABILITY

Aspect of interest   _____________________________________

Your project description  ___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

How did you know about Naele Voice of Africa Group?  __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

What more do you want to know about Naele Voice of Africa _____________________________________________________________________________________________________________________________________________________________________________________________________________________

What is your keen interest in Naele Voice of Africa Group? ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Please explain your purpose of joining Naele Voice of Africa group eg) learning, networking, sharing ideas etc __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Your preferred topic/session in the Naele Voice of Africa __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Would you wish to exhibit/ sponsor Naele Voice of Africa Events? _____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

If there are any conference and meetings, would you like to participate? _____________________________________________________________________________________________________________________________________________________________________________________

Let us know your talent and you would like Naele Voice of Africa group to do or help you what?

__________________________________________________________________________________________________________________________________________________________________________________________________________

Let us know what you would like to do to help African people ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Please advise where should your invitation letter be delivered? ____________________________________________________________________________________________________________________________________

Additional Comments ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

(Remember to pay the registration fee of 5,000/= Tsh’s and you have to keep your self in touch with the group)

 Member’s Signature                                                        Naele Group Youth/member’s Commetee

____________________                                                               ________________________

Date ____________________                                      Date _____________________

Name; ____________________                                  Name; _______________________

Naele Group President

Olais K. Raphael

Sign;___________

Date;__________________

Dr. Jane Goodall at centre Olais K. Raphael (left) Yusuph Masanja (Right)