Young people in action: promoting active citizenship and democracy

June 1-4, 2017-Berlin, Germany

Deadline for registration is May 15, 2017

Family Name (as in passport) *
Your answer
First Name (as in passport) *
Your answer
Current nationality *
Your answer
Country of Residence *
Your answer
Gender *
Date of Birth *
Your answer
Place of Birth *
Your answer
Organisation *
Your answer
Role in the organization *
Your answer
Telephone *
Your answer
E-mail *
Your answer
Emergency contact (Email+telephone)
Your answer
Do you need VISA? *
Place to appeal for visa in your country:
Your answer
Passport Number
Your answer
Date of issue
MM
/
DD
/
YYYY
Valid until
MM
/
DD
/
YYYY
Issued by
Your answer
Meal preferences *
If you chose "Other" in meal preferences, please specify:
Your answer
Special needs
Your answer
What your expectations from this event?
Your answer
Why you are interested in attending the activity?
Your answer
How do you intend to continue working with the topic when returning back to your organisation?
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms