Participant Application Form
ERASMUS+ INTERNATIONAL TRAINING COURSE ON OUTDOOR EXPERIENTIAL LEARNING

TITLE:  Learning values
PLACE: Lagodekhi, Georgia
DATES: 22-31 July, 2022
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Personal Details
Name and Surname *
Date of Birth *
(day.month.year)
Gender *
English Proficiency *
Mobile phone *
(with the country code)
E-mail *
Social media account (e.g. FB, Twitter, Instagram, LinkedIn)
Home Address *
(street, house, postal code)
City/Village *
Region (marz) *
Citizenship *
Passport Details
Do you have a valid passport for travelling? *
Passport expiry date
(day.month.year)
Professional Background
Your main occupation at this moment *
Required
Name of organisation/institution.
Your position in the organisation/institution.
Contact Person from your organisation/institution.
Contact information from your organisation/institution.
(phone number and email)
Motivation, Need, Knowledge, Contribution
 (!!!please answer the questions!!!)
Explain your motivation and needs to take part in this project. *
Not more than 200 words
How will you share your experience after returning from the project? *
Not more than 100 words
Special Needs or Requirements
Please let us know if you require any special arrangements or if there are things we need to be aware of (vegetarian, allergies, impediments, etc.) *
If yes, please specify
Emergency Contact Details
Fill out emergency contact person's details.
Name and Surname *
Phone number *
Relation to the applicant *
(Parent, sibling, friend, spouse, colleague)
*Conditions that will apply if you are selected to this project.
1. I commit myself to participate in the whole process, including:
     - preparation meetings with the organisers,
     - participation in all activities of the Project,
     - participation in the evaluation process and follow-up.

2. I am aware of the following rules:
     - obtaining a travel insurance is my own responsibility and at my own expense,
     - travel costs will be reimbursed after the project via bank transfer up to 180 EUR
       upon presenting the necessary travel documents during the project according to
       Erasmus+ rules,
     - Food and lodging are covered by the project,
     - I understand that the information I provided on my special needs does
       not remove my own personal responsibility for ensuring my own health.

3. PARTICIPATION FEE
    - 20 EUR
     There is no participation fee for YIC members and for participants
     nominated from institutions with agreement to YIC.
I read the above mentioned conditions and take a full responsibility to start my preparation immediately if I am selected. *
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