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Application form for student beneficiaries

Application on Rolling basis | First Cohort begins from February 27, 2022
Only for Haiti residents

Section A: Personal Information

First Name

Last Name

E-mail

Date of Birth

WhatsApp Number

A Parent's or Immediate Guardian's Name

Section B: Education & Profession

What is the name of your School?

Grade (Your current or the highest grade level you have completed)

Do you have any questions for the PeaceX Organisation or the ministry of National Education, Haiti?

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