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Sustainable Agripreneurship Network for Working Professionals in Africa - Malawi Chapter
SANEWOPA MALAWI
MEMBERSHIP APPLICATION FORM
Thank you for your interest in joining SANEWOPA. To help us process your membership application, please answer the questions below:
PART 1. PERSONAL INFORMATION
First Name:
(Required)
Middle Initial:
Last Name:
(Required)
Gender
(Required)
Male:
Female:
Contacts:
Email:
(Required)
Phone Number:
(Required)
Postal Address:
(Required)
.
Which age-group do you fall in?
(Required)
18-25 years old
26-35 years old
36-45 years old
46-55 years old
56-65 years old
66-75 years old
Over 76 years old
What is your marital status?
(Required)
Single
Married
Separated
Widow/Widower
What is the highest level of education you have attained?
(Required)
Primary School Certificate
Secondary School Certificate
College Diploma
Bachelor's Degree
Master's Degree
PhD
PART 2: EMPLOYMENT INFORMATION
What is your main source of income?
(Required)
Employment
Business
If employed, which sector do you work in? For example, education, IT, Banking, Finance etc.
(Required)
If you are in business, what kind of business are you engaged in?
(Required)
PART 3: FARMING INFORMATION
How long have you been farming?
(Required)
Less than one year
1-2 years
3-5 years
6-10 years
Over 10 years
Do you operate more than one farm?
(Required)
Yes
No
How many farms do you operate?
1
2
3
4
5
6
7
8
9
10
More than 10
If you operate more than one farm, answer the questions below for the farm you consider to be your main farm
Where is this farm located?
Area Development District (ADD):
(Required)
Karonga ADD
Mzuzu ADD
Kasungu ADD
Salima ADD
Lilongwe ADD
Machinga ADD
Blantyre ADD
Shire Valley ADD
District:
(Required)
Chitipa
Karonga
District:
(Required)
Rumphi
Mzimba
Nkhata-Bay
Nkhoma Island
District:
(Required)
Kasungu
Mchinji
Ntchisi
Dowa
District:
(Required)
Nkhotakota
Salima
District:
(Required)
Ntcheu
Dedza
Lilongwe
District:
(Required)
Mangochi
Machinga
Balaka
Zomba
District:
(Required)
Phalombe
Mulanje
Thyolo
Chiradzulu
Neno
Mwanza
Blantyre
District:
(Required)
Chikwawa
Nsanje
Extension Planning Area (EPA):
(Required)
Kameme
Mwamkumbwa
Misuku
Lufita
Chisenga
Kavukuku
Extension Planning Area (EPA):
(Required)
North Kaporo
South Kaporo
Mpata
Lupembe
Nyungwe
Vinthukutu
Extension Planning Area (EPA):
(Required)
Nchenachena
Chiweta
Mhuju
Mphompha
Katowo
Bolero
Extension Planning Area (EPA):
(Required)
Malidade
Bwengu
Mpherembe
Mbalachanda
Euthini
Zombwe
Emsizini
Njuyu
Bulala
Eswazini
Kazomba
Mjinge
Manyamula
Mbawa
Vibangalala
Champhira
Khosolo
Luwelezi
Emfeni
Extension Planning Area (EPA):
(Required)
Chikwina
Mpamba
Mzenga
Chitheka
Nkhata Bay
Chintcheche
Tukombo
Extension Planning Area (EPA):
(Required)
Nkhoma
Extension Planning Area (EPA):
(Required)
Chulu
Kaluluma
Chamama
Chipala
Lisasadzi
Santhe
Extension Planning Area (EPA)
(Required)
Mkanda
Kalulu
Mikundi
Chiwoshya
Msitu
Mlonyeni
Extension Planning Area (EPA):
(Required)
Malomo
Chikwatula
Chipukwa
Kalira
Extension Planning Area (EPA):
(Required)
Bowe
Madisi
Chisepo
Mndolera
Mponela
Nalunga
Nachisaka
Mvera
Chibvala
Extension Planning Area (EPA)
(Required)
Nkhunga
Linga
Zidyana
Mwansambo
Extension Planning Area (EPA):
(Required)
Khombeza
Chinguluwe
Tembwe
Chipoka
Katelera
Extension Planning Area (EPA):
(Required)
Njolomole
Kandeu
Nsipe
Bilila
Tsangano
Extension Planning Area (EPA):
(Required)
Chafumbwa
Kabwazi
Lobi
Linthipe
Kaphuka
Kanyama
Mayani
Mtakataka
Golomoti
Bembeke
Extension Planning Area (EPA):
(Required)
Nthondo
Demela
Mngwangwa
Ukwe
Chilaza
Chileka
Mpingu
Ming'ongo
Malingunde
Chitsime
Mpenu
Chigonthi
Chiwamba
Chitekwere
Nyanja
Mkwinda
Mitundu
Mlomba
Thawale
Extension Planning Area (EPA):
(Required)
Nkhunga
Linga
Zidyana
Mwansambo
Extension Planning Area (EPA):
(Required)
Mpilipili
Lungwena
Katuli
Mtiya
Masuku
Maiwa
Chilipa
Mthilimanja
Nansenga
Mbwadzulu
Nankumba
Extension Planning Area (EPA):
(Required)
Nyambi
Chikweo
Nampeya
Nanyumbu
Nsanama
Mtumbwi
Mbonechera
Extension Planning Area (EPA):
(Required)
Bazale
Ulongwe
Rivirivi
Mpilisi
Utale
Phalula
Extension Planning Area (EPA):
(Required)
Chingale
Malosa
Mpokwa
Likangala
Thondwe
Masaula
Ngwelero
Dzaone
Nsondole
Extension Planning Area (EPA):
(Required)
Tamani
Mpinda
Kasonga
Naminjiwa
Waruma
Nkhulambe
Extension Planning Area (EPA):
(Required)
Kamwendo
Thuchila
Milonde
Msikawanjala
Mulanje
Extension Planning Area (EPA):
(Required)
Dwale
Matapwata
Thyolo
Khonjeni
Masambanjati
Thekerani
Extension Planning Area (EPA):
(Required)
Mbulumbuzi
Mombezi
Thumbwe
Extension Planning Area (EPA):
(Required)
Neno
Lisungwi
Extension Planning Area (EPA):
(Required)
Thambani
Mwanza
Extension Planning Area (EPA):
(Required)
Lirangwe
Chipande
Kunthembwe
Mtonda
Extension Planning Area (EPA):
(Required)
Kalambo
Mitole
Mbewe
Livunzu
Mikalango
Dolo
Extension Planning Area (EPA):
(Required)
Makhanga
Magoti
Mpatsa
Zunde
Nyachirenda
What is the size of this farm?
Hectarage:
(Required)
What do you produce?
(Required)
Crops only
Animals only
Both crops and animals
If you grow crops, do you use irrigation?
(Required)
Yes
No
If you use irrigation, what is the source of water?
(Required)
a) River or stream
b) Lake or pond
c) Borehole or water well
If applicable, what are the main crops that you grow for commercial purposes on your farm?
(Required)
If applicable, what are the main types of animals kept for commercial purposes at your farm?
(Required)
What sources of power/energy do you use at the farm?
(Required)
Electricity
Gasoline and/or diesel
Solar
Biogas
Wind power
None
PART 4: GENERAL INFORMATION
How did you learn about SANEWOPA?
(Required)
From a SANEWOPA team member
Referred by a board member
Referred by a member
Social media
Google or online search
Other
If so, what's the team member's name?
(Required)
If so, what's the board member's name?
(Required)
If so, what's the member's name?
(Required)
Which social media platform did you learn about SANEWOPA
(Required)
Facebook
LinkedIn
Twitter/X
Instagram
YouTube
Other
(Required)
Which social media platforms are you most active on? (Choose top two)
(Required)
LinkedIn
Facebook
Twitter/X
Instagram
TikTok
WhatsApp
Other
PART 5: SUBMIT
By submitting this application, I attest that:(select all):
(Required)
The information I have provided is accurate
By submitting this application, I attest that:
(Required)
I meet the criteria for membership of SANEWOPA
By submitting this application, I attest that:
(Required)
I have read and accept to abide by the
membership responsibilities
of SANEWOPA.
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