Application Form
International Youth Exchange "Being Green"
June, 2 - 11, 2017, Ukraine
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Last Name *
Name *
Gender *
Date of birth *
DD-MM-YYYY
City / Village *
Region, Area *
Street and # *
Postcode *
Cell phone *
+38 (operator code) 000-00-00
Home phone
+38 (area code) number
E-mail *
Links to your profiles in the social networks (facebook, VK etc.) *
Main occupation *
Choose from a list
Place of Work / Study *
Company, department, position / School, department, specialisation, year of study
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?
What are your expectations for “Being Green”? And why do you want to be part of this exchange?
Why should we invite you for "Being Green"? How can you contribute to this project to make it successful?
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.
Contact person in case of emergency
Please provide name, email and mobile phone number
Where did you get information about this program? *
Choose from a list
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