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Step Forward- Application form
Dear applicant, by filling in this form you are applying for the youth program "Step Forward" that will happen from 17th April to 25th of April 2019 in Bulgaria.

The project is open for participants resident in Bulgaria, Italy, Greece, Romania, Lithuania and Slovenia.

With your application, you commit yourself for the whole project: preparation, participation in the exchange and follow-up activities.

We will choose as participants the applicants that will look to us more in line with the aim and method of the project, we recommend you to dedicate enough time to complete it fully.

Synergy Bulgaria team.

Country of residence: *
First name: *
Your answer
Surname: *
Your answer
Name you want to be called during the project: *
This will be printed on your name tag
Your answer
How do you identify yourself regarding your gender? *
Date of birth: *
MM
/
DD
/
YYYY
Place of birth: *
Your answer
Address of residence 1: *
Street/square name and number
Your answer
Address of residence 2: *
ZIP code and city
Your answer
Email contact: *
Your answer
Mobile number: *
national prefix + number
Your answer
What is your current occupation or profession?: *
Your answer
What is your level of English?: *
Do you have a medical insurance? *
ex. the European Health Card
Do you have any physical limitation?: *
If yes explain what it is and how it is limiting you: what you can and what you can't do
Your answer
Do you have any diet or allergy?: *
ex. vegan, vegetarian, lactose free, gluten free, allergy to cheese, allergy to bees' bites...
Your answer
Do you take any regular medication? *
Your answer
Contact in case of Emergency: *
Name, surname, phone number, relation to you
Your answer
What are the reasons that bring you to apply for this project?: *
Your answer
What are the challenges that you see in the world around you, ecological, social and economic, especially in your local community? How do you treat these challenges and how would you like to address them? *
Your answer
How would you like to contribute to this Youth Exchange? *
For example: skills and competencies that you would like to share with other participants
Your answer
How do you plan to use what you learn in the project when you go back home?: *
Your answer
How did you find out about this project?: *
Facebook, Friends, Someone recommended it to me, etc.
Your answer
Comments (optional)
Anything else you'd like to add or ask
Your answer
*
I hereby declare that all the above information are true and correct to the best of my knowledge. By submitting this application I confirm that I have read and understood the information written in the info letter of the project file:///C:/Users/39349/Desktop/Step%20Forward5.pdf and the conditions of reimbursement of Step Forward project and I know and accept the conditions of participation. I commit myself to take part for the full duration of the project: preparation, youth exchange and follow-up activities and to participate in the whole evaluation process. I am aware that obtaining a health and a full travel insurance is 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. I understand and agree that the project may be photographed/filmed and used for publications or websites and social networks to provide visibility to the project, the organizations and the public bodies involved in it.
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