Brake The Borders in Yourself
Dear applicant, by filling in this form you are applying for the Project "Brake The Borders in Yourself" that will happen in two steps; the first one, an APV (for a Team Leader) from April 24 to 25, and the second one, a Youth Exchange which will take place from May 21 to 28. Both steps will happen in Pustomyty, Ukraine.

April 23 - Arrival Day
April 24 to 25 - Program
April 26 - Departures

Youth Exchange:
May 20 - Arrival Day
May 21 to 28 - Program
May 29 - Departures

By filling this form you declare that you have fully read and understood the content and the conditions of the info pack of the project: (link)

With your application, you commit yourself to take part in all the phases of the project: preparation, APV (If you are the Team Leader), Youth Exchange and follow-up activities.

We will choose as participants the applicants that will look to us more in line with the aim and method of the project, the more motivated and pro-active. We recommend you to dedicate enough time and care to complete the application form fully.

Be aware that in order to enter Ukraine you must have a valid passport with at least 3 months validity left.
Be aware that in order to take part in the project you MUST have a valid health insurance for Ukraine ( Tessera Sanitaria in NOT valid in Ukraine since is not a member of European Union).

The selected participants will be contacted directly at the email address written in this form with further information about the project and instruction about the membership in New Wellness Education - APS.
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Are you applying as: *
Be aware that the group leader is required to take part in every phase of the project, meaning: preparation, APV, Youth exchange and follow-up activities
Email address: *
We will communicate with you through this contact
First Name: *
Surname: *
Date of birth: *
Address of residence 1: *
Write the name of the STREET and the NUMBER
Address of residence 2: *
Write the ZIP CODE and the name of the CITY
Mobile number: *
National prefix + Number
What is your current occupation or profession?: *
What is your level of English? *
Do you have any physical limitation? *
If yes, please explain what it is and how it is limiting you (what you can do and what you can't do because of it).
Choose your eating option: *
Do you have any allergy? *
ex. lactose free, gluten free, allergy to mushrooms, nuts or other food, allergy to bees' bites... Keep in mind that for us taking care of your diet requires extra efforts. If you are curious to try a different diet then your usual one, do so in another occasion
Do you have a medical insurance valid in Ukraine? *
Be aware that European Health Insurance Card (Tessera Sanitaria) is NOT valid in Ukraine. The insurance provided by New Wellness Education - APS when becoming a member, is not valid outside European Union, thus NOT valid in Ukraine. In order to take part in the project you MUST have a valid health insurance for Ukraine before your departure(eg. travel insurance, private insurance etc..).
Do you take any regular medication? *
If yes explain what medication
Contact in case of emergency? *
Write the name, surname, phone number and what relation this person has with you
What is that calls you to apply for this project? Why do you want to participate? *
Do you have previous experiences in non-formal education? Ex. participating or organizing workshops for young people? Share about them, and about their methodology: *
Mark the box that applies to you: *
How do you plan to use what you learn in the project when you go back home? *
Have you participated in any project supported by European funds before? If yes, tell us about them: *
(e.g. Youth Exchanges, Training Courses, European volunteering, etc.)
How did you find out about this project? *
NWE means New Wellness Education - APS
Is there anything else that you want to add? (optional)
I hereby declare that all the above information are true and correct to the best of my knowledge. By submitting this application I confirm that I have read and understood the information written in the web page of the project: and the conditions of reimbursement as written in the info material provided and I know and accept the conditions of participation. I commit myself to take part for the full duration of the activity: preparation, (APV), youth exchange and follow-up phase and to participate in the whole evaluation process; in case I will break this commitment I will renounce to the travel reimbursement. 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, commit and declare that I will take all the necessary precautions, mandatory and not mandatory ones, in order to keep myself healthy and not get infected nor spread COVID-19 virus. I understand and agree that the project may be photographed/filmed and used for publications or websites and social networks to provide visibility to the project, the organizations and the public bodies involved in it.
I hereby declare that I understand and I commit to the safety rules written on the web page of the project: I understand that if I will not apply myself those safety rules the organizers will be obliged by law to inform the local authorities and, in case I will break the rules again, I will have to leave immediately the youth exchange. I understand as well that the common safety rules don't remove my own self-responsibility and I understand that the risk of contagions, despite being reduced to the minimum, still exist. I commit myself not to take any legal action towards the organizers, the organization "European Ways and Liberty Forum" and "New Wellness Education - APS" other partner organizations in case I will get infected by the COVID-19 during the (APV), youth exchange or while traveling to/from the project.
The organizations "New Wellness Education - APS" as Italian partner of the project and "European Ways and Liberty Forum" as project coordinator and host, take care of protecting your personal information and privacy and takes all necessary organizational and technical measures to ensure that your personal information and privacy are protected according to the current GDRP valid at local, national and international level. By entering the information above, you give your consent to the organizations above mentioned to process it for the purpose of implementing the project Brake The Borders in Yourself. The personal data are collected and processed solely for this purpose. At any time you are entitled to access and correct your personal information, as well as to deletion, transfer and objection. We regard your personal information as a professional secret and we protect it in accordance with applicable legal regulations (international, European and national) and best practices. Note: You can withdraw your personal data approval at any time by contacting us via the email address If you have any questions, please do not hesitate to contact us via I confirm I am aware of this information and I consent the use of my data according to the GDRP for the exclusive purposes related to this project.
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