Application form for Youth Exchange IMMIGRADE
Dear applicant, by filling in this form you are applying for the Youth Exchange "IMMIGRADE: Stories of integration, social cohesion and territorial development" hosted by Ostello dei Balocchi and Legambiente Ligonchio that will happen from 2 till 11 April 2022 (date to be confirmed) in Ligonchio (Reggio Emilia), Italy.

By filling this form you declare that you have fully read and understood the content and the conditions of the info pack of the project that you can find at this link:

With your application, you commit yourself to take part in the activity for its whole duration.
We will choose as participants the applicants that will look to us more in line with the aim and method of the project, the more motivated and pro-active. We recommend you to dedicate enough time and care to complete the application form fully.
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First name *
Surname *
Date of birth *
Place of birth *
Address of residence *
write the name of the STREET, NUMBER, ZIP CODE and CITY where you are officially living
Email contact *
We will communicate with you through this contact
Mobile number *
National prefix + number
Gender *
Do you prefer to share the room with: *
What is your level of English? *
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