Registration Form of WYSP 2019.docxRegistration Form of WYSP 2019.pdfOnline Registration Form Section 1 First Name* Last Name* Passport Size Picture* Date of Birth* Which country will you be a resident of in August 2019?* ---AfghanistanAlbaniaAlgeriaAndorraAngolaAntigua & BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia & HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCentral African Republic (CAR)ChadChileChinaColombiaComorosDemocratic Republic of CongoRepublic of CongoCosta RicaCote d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (formerly Swaziland)EthiopiaFijiFinlandFranceGabonGambiaGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedonia (FYROM)MadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmar (formally Burma)NamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorth KoreaNorwayOmanPakistanPalauPalestinianPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarRomaniaRussiaRwandaSaint Kitts & NevisSaint LuciaSaint Vincent & The GrenadinesSamoaSan MarinoSao Tome & PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSwaziland (renamed to Eswatini)SwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTongaTrinidad & TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab Emirates (UAE)United Kingdom (UK)United States of America (USA)UruguayUzbekistanVanuatuVatican City (Holy See)VenezuelaVietnamYemenZambiaZimbabwe Email Address* Postal Address* City Name* Province* Country* ---AfghanistanAlbaniaAlgeriaAndorraAngolaAntigua & BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia & HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCentral African Republic (CAR)ChadChileChinaColombiaComorosDemocratic Republic of CongoRepublic of CongoCosta RicaCote d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (formerly Swaziland)EthiopiaFijiFinlandFranceGabonGambiaGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedonia (FYROM)MadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmar (formally Burma)NamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorth KoreaNorwayOmanPakistanPalauPalestinianPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarRomaniaRussiaRwandaSaint Kitts & NevisSaint LuciaSaint Vincent & The GrenadinesSamoaSan MarinoSao Tome & PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSwaziland (renamed to Eswatini)SwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTongaTrinidad & TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab Emirates (UAE)United Kingdom (UK)United States of America (USA)UruguayUzbekistanVanuatuVatican City (Holy See)VenezuelaVietnamYemenZambiaZimbabwe Contact* Do you require a visa to enter UAE?* ---YesNo Skype ID (If Available) Do you have a passport? If so, what is your passport number? Current Occupation* StudentEntrepreneurBusinesspersonEmployedOther Institute/University* Degree/Program* Semester* ---12345678 Please provide the name of the educational institution are you currently attending or that you were most recently enrolled at* All the workshops and discussions at the WYSP 2019 will be held in English. How would you rate your English proficiency?* LowMediumHigh Section 2 What areas has your community work/activism focused on so far? (Any three)* Global Youth Leadership to Prevent and End ConflictsAdvocacy at School & Behavioral ChangeClimate Change, EnvironmentWomen & Gender EqualityInterfaith & SocietyHuman Rights & PeaceEntrepreneur ship & Business Development Which of the Sustainable Development Goals (SDGs) does your work relate to the most? (Any three)* GOAL 1: No PovertyGOAL 2: Zero HungerGOAL 3: Good Health and Well-beingGOAL 4: Quality EducationGOAL 5: Gender EqualityGOAL 6: Clean Water and SanitationGOAL 7: Affordable and Clean EnergyGOAL 8: Decent Work and Economic GrowthGOAL 9: Industry, Innovation and InfrastructureGOAL 10: Reduced InequalityGOAL 11: Sustainable Cities and CommunitiesGOAL 12: Responsible Consumption and ProductionGOAL 13: Climate ActionGOAL 14: Life below WaterGOAL 15: Life on LandGOAL 16: Peace and Justice Strong InstitutionsGOAL 17: Partnerships to achieve the Goal Please tell us about a past/current project, social business, organization or campaign you are/were involved in and how this was successful in creating change. Max 1500 characters, including spaces. Why do you want to attend the WYSP 2019? Max 1000 characters, including spaces. If selected, how will you use your attendance at the WYSP 2019 to advance your work and/or goals and increase your impact? Max 1000 characters, including spaces. References: Please provide the name, position and contact details of two references and their relationship to you (e.g. teacher, professor, employer, NGO contact). Reference 1 Name Position Contact Relationship to you Reference 2 Name Position Contact Relationship to you Section 3 You are about to complete your application. Both successful and unsuccessful applicants will be notified via email with the results of the selection process by 30th September, 2019. Please ensure that 'info@worldyouthsummitforpeace.org’ is added to your email providers 'Safe Sender' list so that the email does not end up in your spam folder. I understand, and agree to the terms stated above If I am selected to become a WYSP Youth Leader and attend the WYSP 2019, I commit to participating fully at the summit and becoming an active member of the WYSP 2019 network. I understand that, in addition to making selection decisions, WYSP 2019 may also use the information and data I have provided, in anonymized form, for the purposes stated at the top of this form. Data protection notice: WYSP 2019 will use the information you have given on this form primarily to consider your application for the WYSP 2019. By submitting this form you consent to our processing sensitive personal data about you where this is necessary, for the purpose above. You also agree that we may share your information among our selection committee around the world where this is necessary for the above purpose. WYSP 2019 will treat all personal information in accordance with International law and its own privacy policy. WYSP will not sell or disclose your details to third parties for commercial reasons. Your information will be shared at this stage only with individuals selecting candidates for the event. I understand, and agree to the terms stated above. submit
