YOUTH ADVISORY COMMITTEE APPLICATION FORM
Section 1: Personal Information
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Your Country
*
Please indicate your age
*
Please indicate your Date of Birth
*
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a day
1
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Day
Please select a year
2026
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
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1928
1927
1926
1925
1924
1923
1922
1921
1920
Year
Preferred Language(s)
*
English
French
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Section 2: Background Information
Are you currently running a business?
*
Yes
No
Your Business Name
*
Type of Business
*
Location of Business
*
How long have you operate the business
*
Please describe your involvement in entrepreneurship or economic activities: (Max 200 words)
*
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Section 3: Motivation and Interest
Why are you interested in joining the Youth Advisory Committee? (Max 250 words)
*
What are the key challenges faced by young rural women entrepreneurs in your community? (Max 250 words)
*
What solutions or recommendations would you propose to address these challenges?(Max 250 words)
*
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Section 4: Experience and Skills
Describe any experience you have in leadership, community engagement, or advocacy:(Max 200 words)
*
How do you engage with or represent other young rural women in your community?(Max 200 words)
*
What skills or strengths will you bring to the Youth Advisory Committee?(Max 200 words)
*
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Inclusion and Diversity
Do you identify with any of the following groups? (Optional)
Rural resident
Person with disability
Refugee or internally displaced person
Other
Please specify which group
*
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Availability and Commitment
Are you able to commit 3–4 hours per month for the next 2 years?
*
Yes
No
Are you willing to participate in virtual and occasional in-person meetings?
*
Yes
No
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Declaration
Signature
*
Today's Date
*
-
Month
-
Day
Year
Date
Please attach your CV
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Business profile or portfolio (if applicable)
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Reference list
Kindly add details of your references
Reference 1
Name
*
First Name
Last Name
Organization
*
Title or Position
*
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Reference 2
Name
*
First Name
Last Name
Organization
*
Title or position
*
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Reference 3
Name
*
First Name
Last Name
Organization
*
Title or position
*
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
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