Youth4youth - Enrollment form
The form has to be filled and send online
Activity *
inserire la propria scelta
PARTICIPANT DETAILS - DATI PARTECIPANTE
please, fill in with data related to participant person
Surname (Cognome) *
Your answer
Name (Nome) *
Your answer
Place of birth (Luogo di nascita) *
Your answer
Date of birth (Data di nascita) *
Please, check carefully about the YEAR, you can not be born in 2020
MM
/
DD
/
YYYY
address (Indirizzo) *
Street, n. , code
Your answer
town (città) *
Es. Boves (CN)
Your answer
email (participant) - email (partecipante) *
Your answer
Telephon Number- WhatasApp (Telefono - WhatsApp) *
whatsapp will be used as connection of participants
Your answer
ID (doc identità) *
ID number (Documento d'identità - numero) *
es AS 147652
Your answer
Expiry date (Scadenza documento identità) *
check twice the data you entered, especially the year of expire
MM
/
DD
/
YYYY
CONTACT PERSON FOR EMERGENCY/ PERSONA DI CONTATTO PER EMERGENZE (GENITORE)
Name and Surname (Nome e cognome) *
Your answer
email *
Your answer
Telephone number (contatto telefonico) *
Add international code in the format +xx
Your answer
MOTIVATION / MOTIVAZIONE
I'd like to take part in the activity ... / Voglio partecipare allo scambio .... *
Explain the motivation you have to take part in it/ spiega la tua motivazione
Your answer
Coming back home from the activity I take responsability to disseminate the activities results and Erasmus+ opportunities /Tornando dallo scambio/training mi impegno a far conoscere il programma Erasmus+ e (solo per training) ad utilizzare quanto appreso nel TC in attività nell'associazione. *
Food requirements/ Esigenze alimentari specifiche *
Required
Allergies or other specific issues/ allergie o altre segnalazioni specifiche *
Please, let us know about eventual issues or illness in order to better support you in the activity / Segnalaci per cortesia ogni problematica o malattia cosi da poterti supportare al meglio durante l'attività
Your answer
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