Application to STEAM+
Youth Exchange, 20-27 September 2017, Iași, Romania
First name
Surname
Name you want to be called in the event:
Gender:
Required
Country of residence:
Required
Nationality:
Date of birth and place of birth:
E-mail:
Phone number:
Facebook profile link:
Level of English:
Study or Occupation:
Are you with fewer opportunities?
Diet / Allergies / Special Needs:
Contact person in case of emergency (full name, address, phone number, relationship with you)
Comments
Focus Questions
How did you find out about this opportunity? Who recommended, where did you see this opportunity?
What is your motivation to join in STEAM+?
How do you expect to improve by participating in this event?
What organization(s) are you connected with?
What is your experience until now regarding STEAM (science, technology, engineering and math)?
What is your international experience until now?
Are you willing to do a follow-up campaign?
I agree that group photos and videos (where 2 or more participants are visible) taken during the project can be fully used in promotional materials by Synergy Association and/or project partners:
Submit
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