Play Forward - Application Form
Dear one,

Welcome to the Application Form of Play Forward Exchange Project.

You are about to fill in your application to the project. There are 3 parts in this form.
Filling the form will take you approximately 10 to 20 minutes depending on your answers.

The selection of group leaders and participants happens from each partner organization in cooperation with us.
In case you are selected to take part in the Project, you will receive a Confirmation Letter with more details about your arrival and participation in the activities of the Project. If you have received this letter, you can start arranging your travel.

In case we meet you in Ommen, we would like to get to know more about you, your motivation coming to this project, your learning goals and outcomes you want to achieve, your experience so far and practical aspects to support us in the organization of the exchange.

We keep your personal data private. It will not be shared with a third party in any case.
If you have any question or need clarification, contact us at: info.oldevechte@gmail.com

Colorful Greetings,

Cathy Manousaki
& Olde Vechte Team

Play - Learn - Create
Personal Information
Country of Residency *
Your answer
Your name *
Your answer
Your surname *
Your answer
Name you want to be called in the event *
Note that this name will be on your nametag.
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Place of Birth *
We ask this information so that we can include it in your Youthpass, as asked by Erasmus+. Please write: City and Country.
Your answer
Age *
Your answer
Preferred Pronoun *
We value the respect on individuals gender identity. If you are not familiar with what a pronoun is, please read this resource: https://uwm.edu/lgbtrc/support/gender-pronouns/ . It is one of the many resources, which can be found online.
Your answer
How do you identify yourself regarding your Gender? *
We ask this in order to achieve gender balance required by Erasmus+ programme.
Your answer
Address, Zip code, City, Country *
Your answer
E-mail *
Provide us with a valid e-mail address as it will be used for further communication with you.
Your answer
Telephone number *
Preferably mobile number. Please also include your country's code.
Your answer
Contact person in case of Emergency *
Please fill in the field with: full name of the person, relationship to you, address of the person, telephone number of the person
Your answer
Level of English *
Food requirements *
Please, specify your dietary needs.
Allergies *
Specify if you have any type of allergy we should be aware of. Specially allergies connected with food.
Your answer
Do you have any kind of physical limitation? *
If so, please specify.
Your answer
Do you face geographical obstacles? *
Such as: living in a small village or in the countryside with no social infrastructure, living isolated?
Your answer
Do you face any social obstacles in your life? *
Examples of social obstacles: discrimination based on your gender,sexuality, ethnicity, religion etc, coming from broken or single families, limited social skills etc.
Your answer
Do you have a medical insurance valid in the Netherlands? *
According the Dutch law, you need to have a medical insurance, valid in the Netherlands.
Next
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms