çöp(m)adam Empowerment by Design Application Form
The çöp(m)adam Residency for Innovation in Sustainable Design and Social Empowerment
Name *
Place of Residence *
Profession / Field of Study *
Date and Place of Birth *
Professional Motivation (please describe briefly) *
Personal Motivation (please describe briefly) *
Please check the boxes for the topics that you have experiences of: *
Required
Financial requirments: accomodation
Clear selection
Financial requirments: the cost of the residency programme without accomodation is 10 euros daily. Are you able to cover this and possible accomodation costs?
Clear selection
How did you hear about us?
Please provide your contact information (email and skype / whatsapp / viber / phone number)
Languages you are comfortable speaking on a conversational or work level *
Required
Anything you would like to ask or say (portfolio, life story, special needs, and so forth...)
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