Summer Youth Programme Application - - careepilepsyethiopia.org

Applicant Details

Step 1: Full Name*

Date of birth*

Date of birth

Age*

Gender

Female
Male

Address - City/Sub-city/Woreda*

E-mail*

Phone Number*

Message

Programme Track

Which programme track are you applying for?*

Why are you interested in this programme?*

What do you hope to gain from the programme?*

Have you volunteered or joined a youth/community activity before?*

If yes, briefly describe your experience.*

Education

Current grade/year of study*

Areas of interest*

Which skills would you most like to develop?*

Availability

Are you available for the full five-week summer programme?

Yes
No
Not sure

Which days are you generally available?

Monday

Tuesday

Wednesday

Thursday

Friday

Sunday (last Sunday of the month for half a day)

Emergency contact full name

Emergency contact full name*

Relationship to applicant*

Emergency contact phone number*

Parent/guardian consent

Are you under 18?

Yes
No

Parent/guardian full name*

Parent/guardian phone number*

Parent/guardian consent: I confirm that I am the parent/legal guardian of this applicant and give permission for them to apply for the CareEpilepsy Ethiopia Summer Youth Programme 2026. I understand that I remain responsible for their safety, health needs, transport, belongings, and conduct. CareEpilepsy Ethiopia may contact me about their application or participation.

Agreement and submission: Applicant declaration

I confirm that the information I have provided is correct. I understand that submitting this form does not guarantee a place, and that CareEpilepsy Ethiopia may contact me for further information or interview.

Submit Application

Thank you for applying to the CareEpilepsy Ethiopia Summer Youth Programme 2026. We have received your application and will contact shortlisted applicants with the next steps.