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" Empowering Youth Through EVS " Training Course
Venue : Lefkas , Greece 11.12.2014 – 21-12.2014
This form must be completed in English by Sunday 19th October 2014
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Personal Information
First Name
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Last Name
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Postal address (street, number, city, post code, country)
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Contact No. (mobile)
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E-mail
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Gender
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Date of Birth
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ID/Passport No
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Please explain your role in the organization
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Your Experience
Please provide information regarding your current work/study and your main tasks/responsibilities within your organization (if different from above) (max 5 lines )
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What makes you qualified for this Training?
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Motivation, Expectations and Follow Up
What is your motivation for participating in this training? What do you expect to gain from this Training?
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Please explain how you would contribute to the training (main ideas you would like to express and/ or good practices you would like to share) Maximum 8 lines
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Level of English
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basic
Other Languages
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Visa Information
Name on PASSPORT
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Passport Number
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Date of Issue
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Date of Expiration
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Place of Issue
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City/Country of Birth
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Address of the embassy where you plan to apply for visa
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Embassy email, telephone and fax number
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If no , Please write the address that the visa should be sent to
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By Pressing Submit , I certify that the above-mentioned information is correct and I commit myself to participate actively in the Training
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