Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Name *FirstMiddleLastEmail *EmailConfirm EmailPhone Number *Date of birth *dd/mm/yyNationality * *UgandanUgandanKenyanRwandanTanzanianGhanaianGender * *MaleMaleFemaleOthersName of Institution *Field of Study *Qualification Obtained *MastersBachelorsDiplomaCertificateExpected Date of Graduation *MM/YYYYAre you currently enrolled as a student? *YesNoIf yes, indicate your current program and yearcurrent program and year and associated Institution Do you have prior experience in agriculture? *YesNoIf yes, please provide details on your previous experience in agriculture (job title, responsibilities, duration, etc.): *Select the preferred field of PlacementDairy FarmingCrop FarmingLivestock HandlingGreenhouse ManagementPoultry FarmingOther (please specify)English Proficiency LevelBeginnerIntermediateAdvancedNativeDo you speak any other languages? (Please list and indicate proficiency level *Do you have any medical conditions or allergies? YesNoDo you have any dietary restrictions? YesNoCan you perform physically demanding tasks associated with farming activities? YesNoSubmit
