Virtual Learning: Beneficiary Selection
Thank you for taking the time to fill this form. As we remain committed to providing access to quality education, good health and a happy community to more amazing children across several communities, we invite you to fill this form with the most accurate information to enable us to be able to make the best decisions in regard to having you as a part of our Virtual Learning beneficiaries. Feel free to contact +234 (0) 805 856 4090 for questions in regard to filling this form.
First Name
*
Last Name
*
Sex
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Female
Male
Others
Phone Number
*
Name of Community
*
Who are you living with?
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Guardian's Name
*
Guardian's Phone Number
*
School Name
*
Current Class
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How long have you been with Slum2School?
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Would you like to be a part of Slum2School's Virtual Learning?
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Yes
No
Justification for the answer above
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Are you computer literate?
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Yes
No
Do you have access to electricity?
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Yes
No
Name of Guarantor
*
Phone Number of Guarantor
*
Upload a High Quality passport photo of you
*
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