Application Form
"The Vintage Project"
- European Solidarity Corps-
Short term project
Nicosia District, Cyprus
01/03/2019 until 29/03/2019
Name *
Your answer
Surname *
Your answer
Address(street, Town, Postal Code) *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Email Address *
Your answer
Facebook profile address
Your answer
Phone number (with country code) *
Your answer
Contact person in case of Emergency
Please provide the full name of a person that we can contact with in case of emergency as well as a phone number and a valid e-mail address
Your answer
Do you have a special diet? *
Your answer
What is your present health condition? *
If you have any health situations the we need to take in account during the training, please descried including the use of medication.
Your answer
Do you have medical insurance valid in Europe? *
What is your current status? *
Student, Unemployed, Employed , free lancer etc. In which Field?
Your answer
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