Application Form
International Youth Exchange "Being Green"
June, 2 - 11, 2017, Ukraine
Last Name *
Your answer
Name *
Your answer
Gender *
Date of birth *
DD-MM-YYYY
Your answer
City / Village *
Your answer
Region, Area *
Your answer
Street and # *
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Postcode *
Your answer
Cell phone *
+38 (operator code) 000-00-00
Your answer
Home phone
+38 (area code) number
Your answer
E-mail *
Your answer
Links to your profiles in the social networks (facebook, VK etc.) *
Your answer
Main occupation *
Choose from a list
Place of Work / Study *
Company, department, position / School, department, specialisation, year of study
Your answer
English *
Please, evaluate your level of foreign language proficiency on a scale of 1 to 5 (1 - basic; 5 – excellent):
Basic
Excellent
Have you ever been part of a youth exchange?
If yes: When, where, subject of the exchange and personal experience? If no: What does a good youth exchange look like to you?
Your answer
What are your expectations for “Being Green”? And why do you want to be part of this exchange?
Your answer
Why should we invite you for "Being Green"? How can you contribute to this project to make it successful?
Your answer
Do you have any special needs or requirements that the host organisation should know about?
E.g. mobility, medical needs, allergies, dietary restrictions, smoker/none smoker etc.
Your answer
Contact person in case of emergency
Please provide name, email and mobile phone number
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Where did you get information about this program? *
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