Application form - Care to Communicate
Through this application you are applying to participate in the "Care to Communicate" Experiential Learning Youth Program that will take place in Adamov, Czech Republic. Read carefully all the questions and take your time to answer them in detail.

Timeframe of the project:

Arrival day: 11th May from 5pm until 7pm
Start of the program: 12th May at 10am
End of the program: 20th May around 7pm
Departure day: 21st May until noon

Before applying, read carefully our Infoletter and in case you have any questions contact your sending organisation or write us at brnoconnected@gmail.com.

This application form has 3 parts:

1. Personal details
2. Motivation and Desired Outcomes
3. Extra questions and Declaration

Enjoy the process!
Care to Communicate Team

Country of residence *
Name *
Your answer
Surname *
Your answer
Gender *
Date of birth *
MM
/
DD
/
YYYY
Age at the beginning of the project *
Your answer
Nationality *
Your answer
E-mail *
Your answer
Phone number *
With international code
Your answer
Full address *
Street, number, zip code, city, country
Your answer
Occupation/Profession *
Your answer
Level of English *
Link to Facebook profile *
Your answer
Do you have any dietary needs? *
All meals will be fully vegetarian. If you have any other specific diet, let us know.
Contact person in case of emergency *
Full name, Address, Phone number, Relationship to you
Your answer
Do you have any health problems, disabilities, allergies or health limitations? *
Your answer
Are you currently unemployed?(it doesn´t count if you are a student) *
If yes, please describe in more details your current situation
Your answer
Did/do you have any educational problems (e.g. dropouts from school)? *
If yes, please describe in more details
Your answer
Do you belong to a minority? *
If yes, please describe in more details
Your answer
Are you coming from an incomplete family? *
If yes, please describe in more details
Your answer
Are you living in a conflict country or region? *
If yes, please describe in more details
Your answer
Do you face geographical obstacles (e.g. living isolated, in a rural region, etc.)? *
If yes, please describe in more details
Your answer
Do you consider yourself a less-opportunity person? *
In Erasmus+ programme, people fitting in some of the previous criteria are considered as people with fewer opportunities, but we also want to know if you would consider yourself to be one.
Your answer
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