Registration Form

First Name

Last Name

Email *

Phone Number *

Date of Birth *

Gender

Nationality

City

Address 1 *

Town/City *

State/Region *

Postal/Zip Code *

Which country do you live currently* *

Please Select Program

We encourage you to make your own assessment of what you may risk by being an intern/trainee of this programme. We acknowledge contexts change all the time, so we offer regular opportunities to remove yourself from the programs/or suspend communications.

The Fortune Entrepreneur is a hybrid program, so it is important you answer the following question.

Do you have regular access to internet? *YesNo

Do you have access to a laptop/desktop? *YesNo

More about you

What is your level of spoken English? *BeginnerIntermidiateAdvance

Your answers to the following questions will not impact your application to the Black Creative Star, neither will this information be shared outside the team without your prior consent.

Gender*

We welcome applications from underrepresented groups, e.g. those who consider themselves to have a disability, LGBTQ, refugees/internally displaced peoples as well as other marginalised groups. If you feel that this applies to you, please feel free to let us know below.

Gender *

Emergency Contact

Full Name *

Phone *

Email *

Relationship with applicant *

What knowledge and/or skills do you have that will enhance your participation as a Fortune Entrepreneur programs?

Personal Statement

Please tell us about yourself in an attached personal statement that is 500 words or less. When writing your personal statement, you may find it helpful to consider the following questions:

• What in your life story makes you special, unique, or impressive?

• What interests you about the Fortune Entrepreneur for which you are applying and how did you learn about it?

• Why should you be chosen above the other applicants?

Add Passport Phograph

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How did you hear about us?* *

By checking this box, I verify all the information in this application is true. I agree that if chosen for the program, I will participate in ALL program activities, including from the orientation to the final activities.