YMBT MODULE REGISTRATION FORM
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Step 1
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Step 2
First Name
*
Please enter your first name
Last Name
*
Please enter your last_name
Other Name(s)
Please enter your other name(s)
Ghana Card PIN
*
GHA-
Please enter ONLY the digits. Ignore the "GHA" !
Please enter Ghana Card Number
Date of Birth
*
Please enter date of birth
Email
Please enter valid email
What is your Sex?
*
Male
Female
Please choose your Sex
Residential Address
*
Please enter your Residential address
GPS Address
Please enter your GPS address
Town
*
Please enter town name
Region
*
Choose Region
Ashanti
Please choose region
District
*
Choose District
Please choose region
Next
Next of Kin
*
Please enter Next of Kin's name
Phone Number of Next of Kin
*
Please enter valid phone number
Your MOMO Network
*
Choose MOMO Network
MTN
AirtelTigo
Vodafone
GLO
Please enter your Momo network
Your MOMO Number
*
Please enter ONLY a registered MOMO number linked to your Ghana Card!
Please enter valid phone number
Educational Level
*
Choose Educational Level
BECE
WASCE/SSCE
HND
Degree
Masters
NVTI Proficiency I
NVTI Proficiency II
NVTI Proficiency III
NVTI Foundation Certificate
NVTI Certificate I
NVTI Certificate II
Phd
None
Please choose Educational Level
Please select a module
*
Choose Module
Youth in Modern Building Technology
Please choose a module
I do hereby declare that to the best of my knowledge, the Information given in the application form is correct.
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