Register to Our Program
Name
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First Name
Middle Name
Last Name
Phone Number
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Format: (000) 000-0000.
Email
example@example.com
Select your Location
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Juru
Basecamp
Rubondo
Other
Your Village Name
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Level of Education
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Which program do you plan to attend?
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Entrepreneurship
Computer Literacy
English Language
Hairdressing
MHPSS
Other
Preferred Training Location
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Rubondo
Juru
Basecamp
Online
Other
I would like to receive email updates regarding my registration
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File Upload : ID, Passport photo,...
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