PrefixMr.Mrs.Ms.Mx.MissDr.Prof.

First Name

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Date of Birth *

Sex *MaleFemale

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District of Origin *

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OccupationCurrent OccupationStudentPublic SectorBusiness OwnerFarmerCivil SocietyCommunity LeaderReligious LeaderOther

Why Do You Want to Join ROOTS?Please select all that applyI want to help improve my community.I want to contribute to national development.I want to promote accountability and good governance.I want to volunteer in community activities.I want to support community projects.I want to meet like-minded citizens.I would like to become a ROOTS Ambassador in the future.Other

Areas of Interest Which activities would you like to participate in?Check all that apply.Community DevelopmentYouth EmpowermentWomen’s EmpowermentEnvironment & Climate ActionInfrastructureGovernance & AccountabilityFundraisingCommunications & Social MediaEvents & MobilisationOther

How Did You Hear About ROOTS?FriendRoots AmbassadorSocial MediaRadioTelevisionCommunity EventWebsiteOther

ROOTS CREED As Citizens of Sierra Leone: • We know deep in our bones that we are a resource-rich country that has suffered unnecessary poverty for many years. • We recognise that division by group, region, or tribe has made it harder to overcome poverty. • We believe that if the government and political parties commit to open and efficient contracting, Sierra Leone will have sufficient resources to take care of itself. • We commit to changing how governance and politics are practised. • We commit to amplifying ROOTS ideals and working with others to make Sierra Leone better. Do you agree?YesNo

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