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Raffle Draw Participation Form
Africa Explorers Foundation
Please read carefully and fill all that apply to the best of your knowledge.
Note: You may not participate in this raffle draw if either of your immediate parents are of Africa origin or you currently holds a citizenship of an Africa nation, but you may benefit from our subsidized trip funding through a different application form available on this website.
Name:
(Required)
Address:
(Required)
Telephone:
(Required)
(Required)
Mobile
Home
Work
Email:
(Required)
How do you hear about us?
(Required)
Were you referred?
(Required)
Yes
No
Name of referral:
(Required)
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
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 if the draw was never drawn, I shall be entitled to the refund of my entry cost.
I acknowledged that after winners emerge, and I did not win, I may be offered an opportunity for a subsidized trip by the foundation at management’s discretions.
I acknowledged that the foundation shall not be liable if I did not emerge a winner in the raffle process or offered a subsidized trip.
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:
MM slash DD slash YYYY
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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