TechUpYouths Application – Julie Outreach Foundation

SECTION A — Personal Information

First Name

Last Name

Date of birth

Gender

Place of Birth

Country

City / Town of Residence

Full Residential Address

Phone Number

WhatsApp Number(If different from the phone number)

SECTION B — Educational Background

Highest Level of Education Completed

Name of School / Institution (most recent)

Field of Study / Specialty (if applicable)

Year of Graduation / Expected Year

Current Student?

Yes No

SECTION C — Technology Experience

How would you rate your current tech skills?

Complete beginner — no tech background Basic — I can use a computer/phone Intermediate — some tech knowledge Advanced — I work with tech regularly

Do you own or have regular access to a computer / laptop?

Yes, I own one Yes, I have shared access No, I do not have access

Do you have regular access to the internet?

Yes, reliable access Yes, but limited slow No, I do not have access

Have you ever taken any tech course or training before?

Yes No

If yes, briefly describe what you studied:

Why do you want to join the TECHUPYOUTHS program?

What challenges do you currently face in starting a tech career?

Are you available for the full 8-week program duration?

Yes, fully available Mostly available (please explain below) Not sure

If not fully available, please explain:

Do you have any other commitments (work, school, etc.) during the program?

No other commitments Part-time work School / university Other (specify below)

If other commitments, please specify:

How did you hear about TECHUPYOUTHS?

Full Name

Relationship to Applicant

Phone Number

WhatsApp Number (if different)

Address (if different from applicant)

Declaration

All information provided in this application is true, accurate, and complete to the best of my knowledge.
I am between 18 and 30 years of age.
I understand that a registration fee of 20,000 CFA is required to confirm my participation and will be paid upon acceptance.
I commit to attending the full 8-week TECHUPYOUTHS program and actively participating in all sessions.
I understand that submitting this form does not guarantee a place in the program, and that selection is subject to available seats and eligibility.
I give consent for Julie Outreach Foundation to use anonymized data and photos from the program for reporting and promotional purposes.

I have read and agree to the declaration above.

JULIE OUTREACH
FOUNDATION

JULIE’S OUTREACH
FOUNDATION

Declaration

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TECHUPYOUTHS

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Declaration

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JULIE OUTREACH
FOUNDATION

JULIE’S OUTREACH
FOUNDATION