APPLY NOW TO BECOME A YA ; Name Become a Youth Ambassador and help raise awareness on an issue that affects your friends, family and the community at large. Join the Youth Movement of Youth Ambassadors actively working to prevent gender based violence in Albania. Name Emri Mbiermri Contact Email Your Facebook Age Date of Birth Gender Female Male School School Grade Grade Klasa V Klasa VI Klasa VII Klasa VIII Klasa IX Viti I Viti II Viti III City Region Region Tirane Berat Diber Durres Elbasan Fier Gjirokaster Korce Kukes Lezhe Shkoder Vlore City City Tirane Berat Diber Durres Elbasan Fier Gjirokaster Korce Kukes Lezhe Shkoder Vlore Other Why do you want to become a YA? Why do you want to become a YA? What do you want to change in your school or community? What do you want to change in your school or community? Age Consent * I am at least 10 years old and agree to FuqizimiRinor.com policy privacy and term of use Submitting this application form, hereby I pledge to be part of all the activities that Women’s Network Equality in Decision Making will organise in the framework of this initiative.