YEA REGISTRATION

GARMENT TRAINEE REGISTRATION FORM

What is your name? *

Last Name/Surname *

Please enter your last_name

First Name *

Please enter your first name

Other Name(s)

Please enter your other name(s)

State your Gender? *

Male

Female

Please choose your Sex

How can you be reached? *

Your MOMO Network *

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

Name of Next of Kin *

Please enter Next of Kin's name

Phone Number of Next of Kin *

Please enter valid phone number

Where do you stay? *

Residential Address *

Please enter your Residential address

GPS Address

Please enter your GPS address

Town *

Please enter town name

Region *

Please choose a region

District *

Please choose a district

What is your highest educational level *

Educational Level *

Please select your Educational Level

What is your Date of Birth? *

Date of Birth *

Please enter your date of birth

Your Identification *

Ghana Card PIN *

GHA-

Please enter ONLY the digits. Ignore the "GHA" !

Please enter your Ghana Card Number

Please upload the front part of your Ghana Card *

Please upload the back part of your Ghana Card *

Do you have any Disability? *

Yes

Please choose whether or not you have a disability

If Yes, what is your disability status? *

Please enter what form of disability

Specify your form of disability*

Choose one of the following. *

Please select your expection

I do hereby declare that to the best of my knowledge, the Information given in the application form is correct.