Académique Documents
Professionnel Documents
Culture Documents
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(First name)__________________________________________
____________________________________________________
E-Mail Address:________________________________________
University: Name:______________________________________________________
Address:_____________________________________________________
Ambition:_____________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
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Hobbies:______________________________________________________________________________
Special Talent:__________________________________________________________________________________
Vital Statistics
Hair color: ________________ Eyes color:_______________ Height:_____________ Weight (Kg):__________
Shoe size:__________________________________________________________________________________
Other Details
Have you ever been chosen to be a leader? _____________ When? __________________________
Movie:____________________________ Actors/Actress:___________________________________
Song:______________________________ Singer:_________________________________________
Address:______________________________________________________________________________________
_________________________________________________________ Tel:_________________________________
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Fathers name:_______________________________________ Occupation:_______________________________
Address:______________________________________________________________________________________
__________________________________________________________ Tel:________________________________
Is there anyone travelling with you to Zambia, if yes, please list name & relationship
Name:_____________________________________________ Relationship:_______________________________
“ I declare that the above answers are true to the best of my knowledge and that I will abide by the regulations
governing Zuri Africa Program. I understand that I will be disqualified if any information I have given is found to be
incorrect”.
Address:______________________________________________________________________________________
Tel No.: (Area Code & No)_________________________ Fax No.:(Area Code & No.)_________________________
E-mail(s):_____________________________________________________________________________________
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information, which is privileged and confidential. Accordingly any dissemination, distribution, copying or other use of this message or any of its
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Contestant’s Measurement
Name:
Height:_______________________ (inches)___________________(cm)
Weight:_______________________(LBS)_____________________(kg)
Participant’s Declaration
Participant’s Name:
(Name)___________________________________________________________________________
Participants Address:________________________________________________________________
Being the above mentioned contestant, I hereby declare and agree that I have read and understood all
the forgoing. I hereby agree to participate in the forthcoming Zuri Africa Queen program in accordance
with the terms and conditions set by the Zuri Africa cultural and leadership program and abide by the
decision of the program judges which is deemed final.
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information, which is privileged and confidential. Accordingly any dissemination, distribution, copying or other use of this message or any of its
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Participants Signature:________________________________________ Date:____________________
Country: _________________________________________
Signature:_______________________ Date:____________
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information, which is privileged and confidential. Accordingly any dissemination, distribution, copying or other use of this message or any of its
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