The Leader's Journey Participant Form
Name and Surname *
Your answer
Date of Birth *
dd-mm-yy
Your answer
Gender *
Email address *
Your answer
Mobile number *
including country code
Your answer
Home address *
Your answer
City *
Your answer
English Level for writing *
1: Elemantary 2: Intermediate 3: Upper-Intermediate 4:Advanced 5: Fluent
Writing
English Level for speaking *
1: Elemantary 2: Intermediate 3: Upper-Intermediate 4:Advanced 5: Fluent
Speaking
English Level for understanding (listening) *
1: Elemantary 2: Intermediate 3: Upper-Intermediate 4:Advanced 5: Fluent
Understanding-Listening
Photo (As Link) *
You can use free image hosting service or social media photo link such as facebook, linkedin or twitter. Please give the link which is public available.
Your answer
Passport *
Please choose the type of your passport
Name of your university or institution? *
Your answer
If you are AGU student, Did you take part the USA programme in 2014/2015/2016 or will you take part in 2017?
Motivation
What is your motivation for wanting to participate in this training?
Your answer
What are your expectations for this training course?
Your answer
What experience do you have of being a leader?
Your answer
How do you see yourself as a leader? Think about your style, your approach, your beliefs around you as a leader.
Your answer
How do you see yourself using what you will learn in your local reality?
Your answer
Do you work with any youth organization from Turkey? Do you have any volunteering experience? If yes please mention and provide contact details of reference person from youth field.
You don`t have to answer the question, however it is an asset.
Your answer
How did you receive this project call? *
Please mention the name of website, facebook page or twitter account.
Your answer
Additional comments
Your answer
Special needs or requirements *
Please let us know if you require any special arrangements or if there are things we need to be aware of (diet needs, allergies, impediments…)
Your answer
Please indicate the name and full contact details of a person to be contacted in case of emergency during the Training. *
Name, phone number and email address
Your answer
Please take note of the following conditions that will apply if you are selected to take part in the project: *
I commit myself to participate in the whole process, including: to prepare myself carefully for the Training Course and to do all remote preparation work the team will ask for, to take part for the full duration of the project, to participate in the whole evaluation process. I am aware that obtaining a health and a full travel insurance is my own responsibility and at my own expenses. I understand that the information I provided on my special needs does not remove my own personal responsibility for ensuring my own health. I understand and agree that the training may be photographed / videoed and used on for publications or websites.
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