MEMBERSHIP APPLICATION FOR

BLACK STAR PAN-AFRICAN COMMUNITY IN GHANA

 

 

PLEASE COMPLETE FORM IN CAPITAL LETTERS USING A BLACK OR RED PEN.

CREATE SPAGE AND ADDITIONAL LINES AS NEEDED TO COMPLETE APPLICATION.

 

1.First name: ……………………………………………………………………..........

 

  1. Last name: ……………………………………………………………………......

 

  1. Previous names:………………………………………………………………....

 

  1. Date of birth:………………………………………………………………............

 

   4b. City and Country of birth:……………………………………………………………….

 

  1. Marital Status:………………………………………………………………

 

  1. Details of children to be included on your application Under 18

 

  1. Name……………………………………..…Date of birth ……………………

 

Relationship to applicant………………………………………………………..

 

Medical conditions/special needs…………………………………………………

 

……………………………………………………………………………………

 

Any relevant information……………………………………………………….

 

  1. Name ……………………………………..…Date of birth ……………………

 

Relationship to applicant………………………………………………………..

 

Medical conditions/special needs…………………………………………………

 

……………………………………………………………………………………

 

Any relevant information……………………………………………………….

 


  1. Details of children to be included on your application continued.

 

  • III. Name ……………………………………..…Date of birth ……………………

 

Relationship to applicant………………………………………………………..

 

Medical conditions/special needs…………………………………………………

 

……………………………………………………………………………………

 

Any relevant information……………………………………………………….

 

 

  1. Address: ………………………………………………………………………

 

  1. Home phone:…………………………………………………………………..

 

  1. Work phone……………………................

 

  1. Mobile phone………………………………

 

  1. E-mail:…………………………..…………………………………………….

 

     Working History List Skills

 

  1. Present occupation………………………………………………………

 

  1. Previous work history……………………………………………………

 

……………………………………………………………………………….

 

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  1. Education (please state names and year attended).

 

Primary…………… ……………………………       …………………….                                                                      

 

Secondary…………………….…………………       …………………….

 

High………………………………………….         … …………………

 

College………………………………………….         … …………………


  1. Hobbies and Interest: please check or write basic details.

 

Craft…………………………………….                              

Sports……………………………………

Electrical… …………………………….                                  

Reading (what do you read?)……………

Computing….’………………………….                              

Theatre/concerts/cinema………………

Mechanic………………………………

OTHER………………………………..

 

  1. Political Affiliations Memberships: (present to past)

 

Membership:                                       Dates (approx):

 

………………………………………       ………………………………………….

 

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Associations:

 

……………………………………….       ……………………………………...….

 

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  1. Religious and Traditional Beliefs e.g.(Church, Mosque, Trade

Union, Traditional beliefs) …………………………………………………….….

 

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  1. Please state the contributions that you could make to the project.

…………………………………………………………………………………...….

 

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  1. Community activities/Voluntary work.

List community activities taken part in or any voluntary work undertaken

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  1. Please state what you hope to gain in the project……………………………..

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  1. Please state the reasons for joining the project……………………………..

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  1. How did you hear about the project? What do you believe the project is about? ……..……………………………………………………………………….

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  1. Have you got any criminal convictions? …………………………………….

 

  1. If yes please state the nature and circumstances of said conviction/s and dates……….………………………………………………………………………..

 

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  1. Please provide any supporting/relevant information to your application.

 

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To get started e-mail your Membership Application, 1 Scanned Passport Style Photo, your Passport info with Signature Page, National Criminal Background Check. All of these documents are required by the Government of Ghana to represent your land acquisition. You can send application, background check in PDF and picture, passport page in JPG to e-mail below. General info: e-mail This email address is being protected from spambots. You need JavaScript enabled to view it. - website www.africafortheafricans.org  

I declare that the information given is true.

Signature …………………………………………   Date. .………………..                            

*All information provided on this form is strictly confidential and any applicant concerned about the nature and depth of the security check should please speak to their sponsor.