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Wider Horizons - Application form
Dear applicant, by filling in this form you are applying for the youth exchange "Wider Horizons" that will happen from 11th to 20th of July 2018 in Villach, Austria.

By filling this form you declare that you have fully read and understood the content and the conditions of the webpage of the project: http://bit.ly/widerhorizons

The project is open for participants from the Austria, Croatia, Estonia, Greece, Italy and Poland.

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.

wEUnite team

Country of residence: *
Your answer
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
Sex *
Date of birth *
MM
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DD
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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 need translation? *
Do you have any physical limitation? *
If yes explain what it is and how is it limiting you.
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
Do you have a medical insurance valid in Austria? *
ex. the European Health Card
Your answer
Contact in case of emergency *
name, surname, phone number, relation to you
Your answer
Did/do you face any obstacle/difficulty related with your social environment, culture, identity, family, economical situation or do you live in an isolated place? Do you have chronic health problems? *
Explain briefly
Your answer
Is the contribution of 50€ an obstacle for you to participate in this project? If yes explain why *
Your answer
What are the reasons that bring you to apply for this project? *
Your answer
What do you want to improve or learn concerning your personal development during Wider Horizons? *
Your answer
What do you want to improve or learn concerning the topics of culture, cultural filters and cross-cultural communication during Wider Horizons? *
Your answer
How do you plan to use what you learn in the project when you go back home? *
Your answer
What challenges (obstacles, life questions, important decisions, struggles) do you experience in life at the moment? How do you deal with them? *
Your answer
How do you see yourself? How would you describe your approach towards people /yourself/society? What do you perceive as supportive attitudes/patterns/behaviors of yours? What do you see not working - and what would you like to change? *
Your answer
How did you find out about this project? *
Facebook, Friends, Someone recommended it to me etc
Your answer
Comments (optional)
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 webpage of the project: http://widerhorizons.simplesite.com and the conditions of reimbursement of Wider Horizons 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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