YEA REGISTRATION

GLOBAL DIGITAL SKILLS TRAINING REGISTRATION FORM

Personal Information*

First Name *

Please enter your first name

Last Name *

Please enter your last_name

Other Name(s)

Please enter your other name(s)

Date of Birth *

Please enter date of birth

Gender *

Male

Female

Please choose your Sex

Phone Number *

Please enter valid phone number

Email

Please enter valid email

Ghana Card PIN *

GHA-

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

Please enter Ghana Card Number

Please upload the front part of your Ghana Card *

Please upload the back part of your Ghana Card *

Residential Address *

Please enter your Residential address

GPS Address

Please enter your GPS address

Town *

Please enter town name

Select Region *

Select District *

Next of Kin *

Please enter Next of Kin's name

Phone Number of Next of Kin *

Please enter valid phone number

Educational & Professional Background*

Educational Level *

Please choose Educational Level

Are you currently employed? *

Yes

No

Please choose current employment

Name of Organization

Please enter the name of the organization

Job Title

Please enter job title

Tech Skills & Readiness

Have you acquired any tech skills? *

Yes

No

Please select an option

If Yes, specify the skills

Specify tech skill

Are you ready to work remotely after the training? *

Yes

No

Please select an option

What device do you own? (Select all that apply) *

Laptop

Desktop

Smartphone

Tablet

None

Course Selection & Preferences

Which Course are you registering for? *

Please choose course

How did you hear about this course? *

Please choose how you heard about the course

What are your expectations from this course?

Why are you interested in this course?

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

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