Groove Lab - Application Form

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Youth Exchange

23.05-01.06.2024

Kevelaer, Germany

The data in this form is collected solely for the purpose of the upcoming youth exchange program and will not be shared with any other party without your explicit consent, adhering to GDPR regulations. You can have your data deleted upon request.

First Name
*

Last Name

E-mail
*

Phone number (including the country code, for instance +39 for italy)
*

Emergency Contact (Name, Relation, Phone number with country code) *

Gender (F=Female, M=Male, O=Others)
*

Required

Date of Birth
*

YYYY

Country of Residency

(ES=Spain, IT=Italy, PL= Poland, DE=Germany, HR=Croatia)

I live in another country than those listed above. Therefore I cannot take part in this project.

Nationality

(ES=Spain, IT=Italy, PL= Poland, DE=Germany, HR=Croatia, Others)

Other:

From which City are you planning to Travel from to Germany?
*

Are you planning to Travel Green (Car Pooling, Bus, Train -no airplanes-)
*

YES

Are you a person with fewer opportunities? *

Economic: unemployed- low standard of living, low income, dependence on social welfare system- in debt or with financial problems.

Social: facing discrimination because of gender, ethnicity, religion, sexual orientation, disability, etc.- limited social skills or anti-social or risky sexual behaviours- in a precarious situation- (ex)offenders, (ex)drug or alcohol abusers- young and/or single parents; orphans- young people from broken families

Disability: mental (intellectual, cognitive, learning)- physical, sensory- other disabilities

Educational difficulties: with learning difficulties- early school-leavers and school dropouts- lower qualified persons- with poor school performance

Cultural differences: immigrants or refugees or descendants from immigrant or refugee families- belonging to a national or ethnic minority- with linguistic adaptation and cultural inclusion problems

Health problems: chronic health problems, severe illnesses or psychiatric conditions- with mental health problems

Geographical obstacles:- from remote or rural areas- living on small islands or peripheral regions- from urban problem zones- from less serviced areas (limited public transport, poor facilities, abandoned villages

No, I am not

Required

Based on your response to the previous question regarding fewer opportunities, please indicate whether you selected any of those options.

If you did, please press: YES

If not, please press: NO

YES

Do you have any social obstacles, medical needs, mobility limitations, anything that we have to know about you? Please share, so we can make you as comfortable as possible.

Which of the following diets do you follow?
*

Omnivore

Vegetarian

Vegan

Lacto Vegetarian [no eggs, but milk]

Ovo Vegetarian [no milk, but eggs]

Food Allergy [e.g. gluten, lactose...]

Other...

Required

If you selected 'Food Allergy' or "Other" please let us know what we should be aware of.

Which role are you applying for?

Participant (people (21-30 years old), who are interested in movement, health & community

Group leader (people (21+), who have some experience in the organization and facilitation of educational activities for youth and are motivated to assist their national team in all the phases of the project)

both

Please describe yourself in a few sentences.
*

What's your motivation to participate in this project? *

What do you expect to gain or improve from this project?
*

Which of your talents or what knowledge regarding the main topics of this project (movement, health, dance, personal growth, mindfulness, cultural exchange, connection with nature, community building) could you share with the other participants? *

In how many international projects have you participated so far? *

2-5

6-10

more than 10

If you've been part of at least one international project, what was your biggest learning out of it?

How did you get to know about this Project?
*

Facebook

Instagram

Friends Recommendation

News-Letter

Apply&Go App

Other:

If you ticked "Friends Recommendation", who of your friends recommended our NGO to you?

Please confirm, that you are aware and okay with the facts, that you will be sleeping in tents during the whole duration of the project and the activities will be mainly outside.

The tents fit two people each.

I confirm.

Please confirm, that you have a third-party insurance and health insurance (the European Health Insurance Card works for that).
*

I confirm.

Please confirm that you have read the whole info pack about the project carefully and understood it.
*

I confirm.

If you like to receive E-Mails for a future project - opportunities, please confirm that we are allowed to add you to our E-Mail list.
*

I confirm.

I don't confirm.

Is there anything you'd like to add?

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