Application Form
Training course "Embodied Entrepreneurship" | @HOMADE Brivezac | FRANCE | 02.07.2019 - 10.07.2019
Please, submit this form until 15.05.2019 and wait for our confirmation before purchasing tickets!
Personal data
Name and surname *
Your answer
Date of birth *
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Sex *
E-mail *
Your answer
Phone *
Your answer
Residence country *
Emergency contact *
Please, provide name, phone number and e-mail, information about your relation to that person.
Your answer
Occupation *
Your answer
Do you have, or have you ever had, any mental health problems such as depression or anxiety, panic attacks, schizophrenia, etc.? Please, note that this information won't influence selection of the participants - we need it in order to understand how to offer you safe environment and support. *
Your answer
Do you have any physical health problems, medical conditions, allergies or diseases that organizers should be aware of? Any special requests for meals, for example, vegetarian, vegan? *
Your answer
May we take photos and videos of you during the training course and use them for reporting and publicity needs of the project? *
Expectations, motivation and contribution
What are your reasons to apply for this course? What do you expect and hope to gain? *
Your answer
Please, describe briefly your previous experience in non-formal education and work with young people. Do you have a specific experience related to any kind of body and movement based learning or community work? *
Your answer
What kind of body and movement disciplines do you practice? *
Your answer
Are you a part of organisation, educational institution or informal group of youth people? How long have you been involved in it and what is your role and activities in that organisation? *
Your answer
What is the change that you would like to see in yourself and in your life? *
Your answer
What is the change that you would like to see in your society, your surroundings and environment? To what extent are you willing and ready to help to achieve that change? *
Your answer
How would you like to contribute to this project? *
Your answer
Would you be interested in organising a short follow-up workshop back home in cooperation with other participants and with our support, including financial support for covering costs for space or materials? If yes, what kind of event it might be?
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Any other comments:
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Agreement
By submitting this application, I acknowledge that the following conditions will apply if I am selected to take part in this training course:

1. I commit myself to participate in the whole process, including preparation activities and two online learning weeks, full program and duration of the training course and the follow-up, dissemination and evaluation activities.

2. I understand that the information I provided on my special needs does not remove my own personal responsibility for ensuring my own health. Arranging a health insurance for myself for the duration of the training course is my own responsibility.

3. I acknowledge that this training course is a learning process and not a vacation, therefore I am committed to work on my development and manage my own learning, supported by the trainers and peers.

4. I agree with the conditions of accommodation, participation fee, travel expenses and reimbursement, as described in the information pack.

5. I agree that my personal data that I provided in this application form for this project are used for the purposes of this project and shared with representatives of all the partner organisations involved in the project. Personal data are also provided to the Latvian National Agency and European Commission through the Mobility Tool. Personal data will be used in accordance to GDPR (General Protection Data Regulation). I agree that the trainers and organizers can send me information about their future training courses and events.

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