YOUTHEMPOWERMENT INITIATIVE PASSPORT

LAGOS PROVINCE PHOTO

TRAINEE’S BIO-DATA

◆ Name……………………………………………………………………

◆ Age:…………………………………………………………………….

◆ Resident Address………………………………………………………..

…………………………………………………………………………..

◆ Level of Education ……………………………………………………..

◆ Name of Father………………………………………………………….

◆ Occupation of Father …………………………………………………….

◆ Name of Mother ………………………………………………………..

◆ Occupation of Mother

◆ Are you under the care of your Parent/Guardian ………………………

◆ Have you been trafficked before? Yes No

◆ If yes, which country?

◆ Geogrphical Zone ………………………………………………………

◆ Choice of Training:……………………………………………………..

◆ Name of Training Centre……………………………………………….

………………………………………………………………………….

◆ Period of Training ………. from………………… to ……………..

◆ Are you Physically Impaired? Yes No

◆ Means of Identification (provide one)

 Baptism card National ID card

Voters card NIN

◆ What do you intend to do after this training? ……………………………..

….………………………………………………………………………………..

DECLARATION BY TRAINEE

I,................................……………………………………………do solemnly promise

to abide by the rules and regulations of participating in this training program and
pledge to complete the full duration as stated above. I accept to take full responsibility
for any contradictory actions.
Name of Trainee………………………………

Signature of Trainee………………………….

Date ………………………..

DECLARATION BY THE GUARANTOR

The above trainee is known to me. I will ensure his/ her compliance to diligent
learnings, good conducts and to be committed through out the training period. Hence
his/her intent may please be considered for the above training at (name of centre)
….…………………………………………………………………………………

Name of Guarantor ……………………………

Occupation/Status ………………………………

Signature of Guarantor………………………….. Date …………………..

WITNESS BY THE CENTRE DIRECTOR

We have examined the bio-data and other requirement of the trainee and considered
him/her suitable for the said training. The training Institute has no objection to accept
his/her request for training.
Name of Centre Director …………………………

Signature of Centre Director ..……………………

Date ……………………….