Heartbeat application form
From July 7th to 18th 2022, Heartbeat will invite people from 21- 30 years old to a deep dive, an intensive program on emotional intelligence and emotional agility in Ommen, Netherlands.
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What's your name? *
What's your email? *
What is your phone number with country code?
What's your age? *
What's your gender?
Clear selection
Which of the countries below do you have legal residency and/ or nationality? *
Required
Why would you like to join Heartbeat? *
What is your experience on the topics of Emotional Agility and Emotional Intelligence? *
Would you like to facilitate a short workshop for other participants? The experience will be much more diverse & fun if you share your skills! Please specify if you would like to do that and write a short description of the workshop specifying the required skills and level (beginners/intermediate/advanced). *
Do you have any physical or mental condition that you would like to share with us? And if yes, what could support you to fully participate in this training?
Do you have any dietary restrictions? *
I agree that the organizing team can take pictures, records video and audio during the activities as well as I authorise them to use the material created during the activities (photos, videos, and other material, including those with my image). *
I agree that I am responsible for my own travel documents and health insurance, and that by providing the above information on special needs does not remove my responsibility for my own health and safety. *
In case of being selected I commit myself to participate in the whole process, including: to prepare myself carefully and to do all remote preparation work the team will ask for, to take part in the FULL duration of the activities, to participate in the whole evaluation process, and to collect and share all my travel reservation documents and tickets with the admin team. I understand and agree with these conditions. *
Anything else you would like to share with us?
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