Application Form - Training Course Agents of Change October 2019
By filling in this application form, you are applying for participation at the Training Course Agents of Change, which will take place in Hollókő, Hungary between 10th and 20th October 2019 (incl. travel days).
We will contact you as soon as possible to confirm we got your application form and when approximately will we confirm if you are selected. Then, we will communicate the details.
If you have any questions, please contact coordinator Veronika Marková on campleaders@inexsda.cz.
Your name and surname *
Your answer
E-mail Address *
Your answer
Telephone number (with country prefix) *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Permanent Address *
Your answer
Country of residence *
Your answer
Nationality (if different from the country of residence)
Your answer
Temporary Address
If you already think you may go to the Training Course from a different place, that from your permanent address, please let us know by inserting the address you'll be most probably going from (or at least town + country :) )
Your answer
Name you want to be called during the training
In case you'd like to be called in a specific manner by the team and the other participants - we will prepare name tags.
Your answer
Special Needs *
If you have any special needs regarding accommodation, activities, alergies, access - let us know here so we can count on it in advance.
Your answer
Food requirements *
If you have any combination of these or any special diet/what you don't eat, please, specify below in comments.
Which partner organisation do you represent? *
I agree with processing my personal data for the purposes of the project administration and implementation. *
Any comments to this section?
Your answer
Next
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service