Participant Application Form
PROJECT TITLE - "SPEAK UP YOUTH WORK"
DATE: 14-22 OCTOBER 2017 PLACE: KOBULETI, GEORGIA
Personal Information
Surname *
Your answer
Name *
Your answer
Date of birth *
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Gender *
E-mail Address *
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Mobile phone *
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Home Address
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Country *
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Passport Number (for hotel reservation)
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Your Facebook account link( necessary to add in project’s FB group). *
Your answer
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English Abilities
Information About Sending Organization
Name of Organization *
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E-mail address
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Webpage
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Telephone number
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Contact person
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Please describe your role, position and experience in your organisation
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What is your motivation to participate in this project, both personally and professionally? Please share to us also your expectations and contribution. *
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Please let us know if you will have any practical requirements, such as special dietary needs (vegetarian, no pork meat etc.) or any disability arrangements? *
Please indicate us the name and full contact details of a person to be contacted in case of emergency during the training course *
Name, Complete address, Phone number and e-mail
Your answer
1. I confirm to participate in the whole process, including: a) to prepare myself carefully for the training course and to do all remote preparation work the organizer team will ask for, B) to take part in the full duration of the activity C) to participate in the whole evaluation and dissemination process *
2. I am aware that obtaining a health and a full travel insurance are my own responsibility and at my own expenses. I have acknowledge the info-pack provided by applicant organization and agree with all information. *
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