Youth Exchange "What does it means to be European?" - Application form
Scambio Giovanile internazionale a Braga (Portogallo)
9-16 Luglio 2017

ATTENZIONE! Il modulo può essere compilato anche in lingua italiana

First Name *
as on your passport
Your answer
Family Name *
Surname as on your passport
Your answer
Nationality *
Your answer
Date of birth *
MM
/
DD
/
YYYY
Gender *
Complete home address *
Your answer
Postal code *
Your answer
Town *
Your answer
Country *
Your answer
Phone (preferably mobile) *
with full international dial codes
Your answer
Email *
Your answer
Website
Your answer
Language(s) abilities
Please mention all languages in which you are able to work and indicate your level for each of it.
English *
(1-basic, 2-good, 3-very good, 4-fluent, 5-mother tongue)
Basic
Mother Tongue
Language 2
Please specify
Your answer
(1-basic, 2-good, 3-very good, 4-fluent, 5-mother tongue)
Basic
Mother Tongue
Language 3
Please specify
Your answer
(1-basic, 2-good, 3-very good, 4-fluent, 5-mother tongue)
Basic
Mother Tongue
Do you have any special needs or requirements that the host organisation should know about?
E.g. mobility, medical needs, allergies, dietary restrictions, smoker/non-smoker
Your answer
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