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PBS "YOur Culture"
21-28 May 2018 - Recoaro Terme (VI) - ITALY
First Name (as on your passport) *
Your answer
Family Name (Surname as on your passport) *
Your answer
Nationality *
Your answer
Date of birth *
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YYYY
Gender *
Complete home address *
Your answer
Postal code *
Your answer
Town *
Your answer
Country *
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Phone (preferably mobile) *
Your answer
E-mail *
Your answer
Web-site *
Your answer
Please mention all languages in which you are able to work and indicate your level for each of it. Anyway we would like to remind you that main working language will be English. *
English
Other language
Your answer
Other language
Your answer
Other language
Your answer
Do you have any special needs or requirements that the host organisation should know about? E.g. mobility, medical needs, allergies, dietary restrictions, smoker/non-smoker *
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Do you need VISA to reach and stay in the venue of the project? *
Please describe briefly your motivation to participate within this Youth Exchange? *
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What would you like to learn, understand and experience during this Youth Exchange? *
Your answer
Did you take part to other European Projects? *
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Which means of transport are you going to use? *
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Which airport? *
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Date of arrival *
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YYYY
Date of departue *
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DD
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YYYY
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