About you (Please provide your personal
details)
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Enter Above Form Number Here |
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| 1 |
First Name |
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| 2 |
Family Name |
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| 3 |
Gender |
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| 4 |
Date of Birth |
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| 5 |
City/Town of Origin |
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| 6 |
State of Origin |
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Nationality |
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| 8 |
Place of Residence
(Hostel name/other residence while in school) |
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| 9 |
Name of your
Institution |
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| 10 |
Department |
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| 11 |
International
Passport No |
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| 12 |
Course of Study |
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| 13 |
Year of Admission |
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| 14 |
Year of Graduation |
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| 15 |
Contact Address |
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| 16 |
Your E-mail Address |
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| 17 |
Telephone
(including country code) |
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Campus Affiliations
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| 18 |
Please list any
groups you belong to, including any faith-based
groups, if you have a religious affiliation |
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| 19 |
If you do, what is
your position? |
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| 20 |
How often do you
attend your group meetings or gatherings? |
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| 21 |
What is your group
leader’s name? |
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| 22 |
Languages you
speak (List, separate with commas) |
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| 23 |
Computer Literacy |
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| 24 |
How often do you
access the internet? (E.g. once a week, twice a
week, month etc) |
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| 25 |
Name your favorite
youth site? |
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| 26 |
(a) Any added
experience (Tick applicable options) |
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| (b) Other special
talents (List and separate with commas) |
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| 27 |
Membership of any
organization/ other bodies that is relevant to
the course of GCI (these may or may not be
school-based...if listed above, then skip this
question) |
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| 28 |
Awards, Honours/prizes you have won and dates: |
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| 29 |
Any other
information about yourself in 3 sentences or
less including your life vision /goal. |
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| 30 |
In one sentence
please explain why you want to attend this
event: |
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| 31 |
Have you previously
demonstrated leadership abilities or potentials?
If yes, where and when? |
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| 32 |
In your own words
describe “Millennium Development Goals” |
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| 33 |
How have you
contributed to any of the Millennium Development
Goals and name the goal? |
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| 34 |
Please describe any
work you are doing, or hope to do in future, in
relation to HIV/AIDS: |
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| 35 |
Where did you get
information about this program? Name the
person/organization/online: |
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| 36 |
Will you like to
serve as a volunteer at the GCI 2007 event for
the 3 days in Calabar? |
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If yes,
note the following that Persons from Ghana to
volunteer at GCI 2007 should indicate clearly
form sections they want to volunteer. (News and
reports, Securities, Ushers, Admin, Fieldwork,
Projects, Media/ Communications, entertainment,
Logistics, Tours, Decorations and Exhibition.) |
| GCI is
not able to offer any financial assistance for
volunteers, however volunteers would register on
a flat rate of N1, 200 or $50. |
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