Application form | Re-match with yourself
Dear applicant, by filling in this form you are applying for the youth exchange  "Re-match with yourself" that will happen from the 29th October till the 06th November 2022 (28th October 2022 arrival day and 6th November 2022 Departure Day) in Amange, France.

By filling this form you declare that you have fully read and understood the content and the conditions of the info pack of the project:

With your application, you commit yourself to take part in the 3 phases of the exchange: preparation, youth exchange and post-exchange part.

We will choose as participants the applicants that will look to us more in line with the aim and method of the project, the more motivated and pro-active. We recommend you to dedicate enough time and care to complete the application form fully and to communicate to us why it's important for you to get involved.

Deadline for applications: 14th of October 2022
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Current country of residence ? *
Select the place where you are officially resident. In case it is different from the place where you are living, specify it in the "notes" at the bottom of this application form
Are you applying as a Participant or as a National Leader? *
Name *
Surname *
Date of birth *
City of Birth *
Country of birth *
Phone number (including coutry code) *
We will communicate with you through this contact
Email adresss *
We will communicate with you through this contact
In case you need a passport to travel to France, write here the expiration date
ID/Passport number *
Do you have a medical insurance valid in France? *
For example : the European Health Card
European Health Insurance Card (EHIC) number
Your age at the beginning of the youth exchange: *
How do you identify yourself concerning your gender? *
Providing only "female" and "male" as options may be limiting for some people
Level of English *
Contact in case of emergency ( Name, Surname, Phone Number, Relation to you) *
If selected, from which city would you be travelling to Besançon for "Re-match with yourself"? *
What is your current occupation or profession? *
Choose your sleeping option *
Are you vaccinated against Covid-19? *
There is currently no obligation to be vaccinated to participate in the project. We are asking this question in case th situation changes before the beginning of the exchange..
What vaccine did you take? How many doses? Write the date of the last injections
Ex: Pfizer-Biontech, 3 dosis, 3rd dosis made on 21st April 2022
How did you find out about this project? *
Facebook/web page/newsletter of my sending organization; on a group related to international mobility (write the name), on a youth mobility portal (write the name), in a youth centre, from my friend John Brown; Mary Smith recommended it to me etc.
Anything else you would like to tell us?
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