Skip to main content
Welcome to non profit charity platform
Hit enter to search or ESC to close
Close Search
Email
[email protected]
Phone
+1 (734) 643-2551
Visit
5901 Buck Street, Taylor MI 48180
search
Menu
Home
About Us
Participation
Raffle Draw Form
Subsidized Trip Form
(USMPS) Application form
Apply For Educational Scholarship
Partners
Desk of the President
Events
Contact Us
DONATE NOW
search
APPLICATION FOR SUBSIDIZED TRIP
Note: You are not qualified to participate in this subsidized trip if our destination is a country where you hold a citizenship or either of your parents.
Name:
(Required)
Address:
(Required)
Telephone:
(Required)
(Required)
Mobile
Home
Work
What is best form of contacting you?
(Required)
Phone call
Text
Email
Does either of your parents holds citizenship of any African nation?
(Required)
YES
NO
Do you hold citizenship of any African nation?
(Required)
YES
NO
How do you hear about us?
(Required)
Were you referred?
(Required)
Yes
No
Name of referral:
(Required)
I understand any false declaration in the form is an automatic disqualification even if I had earlier been contacted as lucky winner at any process of my application.
I voluntary agreed that this is a free-will participation and that I shall follow any further terms and conditions including customs and immigration laws of our country of destination.
I agreed that signing my name below is taking as my electronic signature and as consent to all above.
First & Last Name:
(Required)
Date:
(Required)
MM slash DD slash YYYY
CAPTCHA
Close Menu
Home
About Us
Participation
Raffle Draw Form
Subsidized Trip Form
(USMPS) Application form
Apply For Educational Scholarship
Partners
Desk of the President
Events
Contact Us
DONATE NOW