IKAMVAYOUTH & THE LEARNING TRUST COMMUNITY COLLABORATION PROGRAMME 2016-2017

GENERAL INFORMATION

1. Name of organisation: *This question is required.

2. NPO Registration number:

3. Website/Facebook page:

4. Work Phone:
This question requires a valid number format.

5. Current Address where the Programme Operates; Building/Street Name

6. Area

7. City

8. Province

9. Postal Code

10. Feeder School Name (schools that you are currently working with) and Number of Learners enrolled in your programme.

11. Primary contact person name and surname:

12. Designation

13. Work Phone: This question requires a valid number format.

14. Mobile: This question requires a valid number format.

15. Email: *This question is required.

16. Alternative email:

17. Secondary contact person name and surname:

18. Designation

19. Work Phone: This question requires a valid number format.

20. Mobile: This question requires a valid number format.

21. Work Email: *This question is required.

22. Alternative Email: *This question is required.

23. Date registered as an NGO This question requires a valid date format of MM/DD/YYYY.

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