Republic of Ambazonia

Section A — Personal Information

Full Name Date of Birth Gender National Identification No. Place of Birth (County) Contact Address Phone Email

Section B — Eligibility Requirements

I am a citizen of the Republic of Ambazonia. I am at least 25 years of age. I am of sound mind and not disqualified under the laws of Ambazonia. I have not been convicted of an offence involving dishonesty, corruption, or misuse of public office. I am registered as a voter in Ambazonia.

Section C — Education & Professional Background

Highest Academic Qualification Occupation/Profession Relevant Leadership/Political Experience

Section D — Constituency Selection

Choose one county and subdivision. Use the search box below to quickly find your county:

Section E — Supporting Documents (Attach)

Copy of National ID or Passport Proof of Voter Registration Recent Passport-size Photographs Curriculum Vitae (CV) Educational Certificates

Section F — Declaration

I, hereby declare that all the information provided in this application is true and correct to the best of my knowledge. I understand that providing false information will lead to automatic disqualification. I agree to the declaration.