Camp Application Form

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FORUM FOR WOMEN IN DEMOCRACY (Attach your)

Passport photo

APPLICATION FORM

Mentoring Young Women for Transformative Leadership


NO. PARTICULARS

1. Full Name

2. Date of birth

3. Age

4. District of origin

5. District of residence

6. Tertiary institution attended

7. Course taken

8. Leadership position(s) held No. Position Held Year / Period

9. Essay title

10. Interests

11. Telephone number(s)

12. Email address

13. Telephone number(s) for next of kin

14. Relationship with the next of kin

Plot 15 Vubya Close, Nakawa-Ntinda Road, P.O Box 7176, Kampala, Uganda. Tel: +256-414-286063,
Fax: +256-414286029, Email: [email protected] Web: www.fowode.org

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