• RACE2BUILD AFRIKA PROGRAM Information Form

    Please fill the form below carefully. If you don't have all of the information, you will need to get it before you can be accepted for the program.
  • Gender*
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  • Parent/Guardian Contact Details

  • Mailing Address
  • Do you suffer from any medical condition/disability that your host family will need to know about?*
  • If yes, please specify from the following*

  • Passport Details

  • Do you have a passport? If so, fill in the information below. If not, get it as soon as the trip is approved by the RACE2BUILD AFRIKA Organization.*
  • Passport Expiration Date
     - -

  • Parent/Guardian Details

  • References

    Please list your references and upload a letter of recommendation below in the Supporting Documents section.
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  • School Record

    Please provide proof of your college/university admissions and a statement from your institution to show no discipline referrals, detentions, or suspensions.
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  • Declaration

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  • Should be Empty: