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Your name *

Your email *

Your Phone Number *

Your Country of Residence *

Your Country of Origin *

Do you have a partner?

Do you have a job? or an activity?

What most influenced your decision to complete this application and reach out to Karine-Kayitesi?

How WILLING and ABLE are you to invest in improving the quality of your life?

In terms of time

In terms of finances

In terms of motivation

Is there anything else we should know while considering your application?

Complete this sentence: Karine-Kayitesi, I really wish to start improving my life.
Today – I have no time to loseIn a Few Weeks – I’m motivated but I’ m not ready to do it now, maybe in a few weeksIn a Few Months – It would be nice to improve my life but it’s not my priority right now, maybe in a few months