Request edit access
Evaluation Meeting Rockin Platform
Training Course - Bant, Netherlands - 22-27 September 2019
Name *
Your answer
Surname *
Your answer
Nationality *
Your answer
Date of Birth *
City *
Your answer
Address *
Your answer
Place of Birth *
Your answer
Passport or ID card number *
Your answer
Telephone number *
Your answer
Email address *
Your answer
Facebook profile link *
Your answer
Contact details in case of emergency (name and telephone number) *
Your answer
English level *
Occupation *
Your answer
How did you found out about this project? *
Please describe your own personal motivation for attending this contact seminar: *
Your answer
Mention 3 qualities that you have and make you the ideal participant for this training course. *
Your answer
Do you have any experience in European projects (youth exchanges, training courses, seminars, etc...)? Please elaborate. *
Your answer
What expectations do you have? What do you want to achieve through this project? *
Your answer
How will you disseminate the results of this mobility, if you are selected? *
Your answer
Are you dealing with any situation of need or any issue? *
Special requirements (allergies, vegetarian, disabilities, hallal…etc) *
Your answer
Please take note of the following conditions that apply in case you get selected:
1. I commit myself to participate in the whole process, including:
- to prepare myself carefully for the event and to do all remote preparation work the team will ask for;
- to take part in the pre-departure meeting with the sending organisation (K.A.NE.);
- to take part for the full duration of the activity (mandatory condition for the reimbursement of travel costs and subsistence costs!);
- to participate in the whole evaluation process;
- to accept the Approval for Filming and GDPR Consent which will be given in the beginning and concern “consenting to K.A.NE. (Social Youth Development) holding and processing your personal data for the following purposes: keeping you informed about news, events, activities and services; contacting you with surveys about current events; using any photographic material, from your activities during the project, in publicity material, in other printed publications that we produce or to submit as evidence of high quality provision”
- being actively involved in the dissemination of the project by writing and delivering to K.A.NE. a short article about my experience up to 1 week after the last day of the project;
- provide photo and video material to K.A.NE. in order to be used in the dissemination process up to 1 week after the last day of the project;
- make a post on social media about the experience together with my national team and tag K.A.NE.;
- respect the deadlines that occur during the project.

2. I am aware that not following the requirements requested from the sending or the hosting organisation or not respecting the deadlines will lead to NOT receiving the travel reimbursement.

3. I am aware that obtaining a health and a travel insurance are my own responsibility and at my own expenses. I understand that the information I provided on my special needs does not remove my own personal responsibility for ensuring my own health.

4. I understand that I will share a room with other persons.
I take note of the conditions that apply in case I get selected and of the fact that I will get my reimbursement only after the whole team comply to the conditions due to the deadlines set *
Thank you for applying!
After the selection process is over, you will be announced via email if you are selected or not to be part of the project.
Never submit passwords through Google Forms.
This form was created inside of Social Youth Development. Report Abuse