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Culture for local development 2017 Application Form
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First name *
Surname *
Date of birth *
Sex (Male/Female) *
Nationality *
E-mail *
Phone number *
Home address *
Occupation *
Membership (school, university, organization, other) *
Describe your motivation for participation in "Culture for the local development" project. *
What do you hope to gain from it?
What are your expectations of the project? *
What does culture for local development mean to you? *
What could be a potential cultural activity in your local environment? *
Please, describe your experience in local cultural projects and paste links to your projects, events, initiatives etc.
NOTE: There’s also a possibility to send your work via e-mail europe@ecs.gda.pl
Language competences: English - working language of the project *
According to the Common European Framework of Reference for Languages
Language competences: Mother tongue
Language competences: other languages
Will you be able to arrange your accommodation independently  in following destinations? *
Contact data to person that needs to be informed in case of emergency (name and surname, address, phone number) *
Special needs (diet etc.)
Where did you get information about the "Culture for local development" from? *
I declare my participation in entire project (three days of workshops & Summer School). In the case of the resignation after my entry has been accepted, I will inform the organizers no later than 20th February 2017. *
I hereby authorize you to process my personal data included in my application for the needs of the recruitment process (in accordance with the Personnel Protection Act of 29.08.1997 no 133 position 883). *
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