Section 1 of 4
Active Imagination for Wellbeing and Mental Health - Youth Exchange Application
Dear applicant,
We are delighted that you are interested in taking part in our Erasmus + youth exchange organized by our organization MLADIINFO ČR in Rašov, Czech Republic from 📅15. 6. to 22. 6. 2026.
Please, take your time to properly fill this form. Before submitting the application, please make sure, that you have read the info pack, available here:
This project is offered to residents of Czech Republic, Bulgaria, Italy, Greece and Lithuania only. Each national team has 5 members.
If you have any questions, please contact your sending organization or us at projekty@mladiinfo.cz.
Mladiinfo ČR team
www.mladiinfo.cz
projekty@mladiinfo.cz
We are delighted that you are interested in taking part in our Erasmus + youth exchange organized by our organization MLADIINFO ČR in Rašov, Czech Republic from 📅15. 6. to 22. 6. 2026.
Please, take your time to properly fill this form. Before submitting the application, please make sure, that you have read the info pack, available here:
➡https://www.mladiinfo.cz/wp-content/uploads/2026/03/ACTIVE-IMAGINATION-FOR-WELLBEING-AND-MENTAL-HEALTH.pdf?fbclid=IwY2xjawQ2VzFleHRuA2FlbQIxMABicmlkETFRT002Yk9sTDg3VkJWdzM1c3J0YwZhcHBfaWQQMjIyMDM5MTc4ODIwMDg5MgABHlRyKLP4YBlBCbRkG7RMwI4IPtC9pwrPHr8TauPjnq1_dYu7Mldw-pnMxvdx_aem_A50zwxu7aIakViXJ-kBApA
This project is offered to residents of Czech Republic, Bulgaria, Italy, Greece and Lithuania only. Each national team has 5 members.
If you have any questions, please contact your sending organization or us at projekty@mladiinfo.cz.
Mladiinfo ČR team
www.mladiinfo.cz
projekty@mladiinfo.cz
Section 2 of 4
Personal Details
First Name
First Name
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Last Name
Last Name
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Date of Birth
Date of Birth
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Your Gmail = GOOGLE E-MAIL
Your Gmail = GOOGLE E-MAIL
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Example: superman@gmail.com
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Country
Country
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Czech Republic
Bulgaria
Italy
Greece
Lithuania
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Do you face any of following barriers or fewer opportunities?
Do you face any of following barriers or fewer opportunities?
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Disability or long-term health condition (physical, visual, hearing, mental health, chronic illness)
Economic obstacles (low income, unemployment, financial difficulties)
Social obstacles (discrimination, limited social support, difficult family situation)
Geographical obstacles (living in remote/rural areas, limited access to services)
Educational obstacles (learning difficulties, early school leaving, low qualifications)
Cultural or language obstacles (migrant background, language barriers)
Other
None of the above
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Section 3 of 4
Let us know a little more about you!
Please briefly introduce yourself.
Please briefly introduce yourself.
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Why are you applying for this specific project?
Why are you applying for this specific project?
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What would you like to learn during this project and how do you think it will be useful for you in the future?
What would you like to learn during this project and how do you think it will be useful for you in the future?
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Do you have any previous experience with the topic of wellbeing, mental health, selfcare?
Do you have any previous experience with the topic of wellbeing, mental health, selfcare?
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What is your experience with Erasmus+ and/or other international projects? In how many Erasmus+ projects have you participated?
What is your experience with Erasmus+ and/or other international projects? In how many Erasmus+ projects have you participated?
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How comfortable are you using English?
How comfortable are you using English?
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I can only understand and say a few basic words and phrases.
I can introduce myself and communicate in simple situations with help.
I can take part in basic conversations and understand the main ideas.
I can express myself quite well and follow most group discussions.
I can participate fluently in discussions and express my ideas clearly.
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Would you like to be a leader of your national group?
Would you like to be a leader of your national group?
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Maybe
No
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Section 4 of 4
Declaration
I agree with following rules of the project:
1) No physical or mental violence.
2) Prohibition of the use of illegal drugs during the entire project.
3) Active participation in the program, and being on time for the project sessions.
4) Arranging travel, health, liability insurance before the project and being responsible for your own acts.
I agree with following rules of the project:
1) No physical or mental violence.
2) Prohibition of the use of illegal drugs during the entire project.
3) Active participation in the program, and being on time for the project sessions.
4) Arranging travel, health, liability insurance before the project and being responsible for your own acts.
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I certify that I have provided complete and accurate information and I hereby confirm my willingness and ability to attend the forenamed project's activity in its full duration. By submitting this application You grant your consent to non-governmental organization MLADIINFO ČR registered at The European Commission's main authentication service (hereinafter referred to as the "Administrator") within the meaning of Regulation (EC) No 2016/679 of the European Parliament and of the Council on the protection of individuals with regard to the processing of personal data and on the free movement of such data and repealing Directive 95/46 / EC on Personal Data Protection) (hereinafter the "Regulation") processed these personal data.
I certify that I have provided complete and accurate information and I hereby confirm my willingness and ability to attend the forenamed project's activity in its full duration. By submitting this application You grant your consent to non-governmental organization MLADIINFO ČR registered at The European Commission's main authentication service (hereinafter referred to as the "Administrator") within the meaning of Regulation (EC) No 2016/679 of the European Parliament and of the Council on the protection of individuals with regard to the processing of personal data and on the free movement of such data and repealing Directive 95/46 / EC on Personal Data Protection) (hereinafter the "Regulation") processed these personal data.
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I certify, that I have read the infopack.
I certify, that I have read the infopack.
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I acknowledge, that this application is binding and in case I am selected, I am willing to participate. I confirm, that I am available for the whole project duration including travel.
I acknowledge, that this application is binding and in case I am selected, I am willing to participate. I confirm, that I am available for the whole project duration including travel.
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I want to register for Mladiinfo ČR irregular newsletter and to learn more about opportunities! Don't worry, we don't spam with not interesting things :) You can sign off anytime.
I want to register for Mladiinfo ČR irregular newsletter and to learn more about opportunities! Don't worry, we don't spam with not interesting things :) You can sign off anytime.
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