Application form for the Youth Exchange Youth vs. Disinfo
Erasmus+ KA1, Youth Exchange
13th - 21st of April 2024
Lhotka u Mělníka, Czechia
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Email *
PROJECT APPLICATION FORM
1. CONTACT DETAILS
Gender *
First name *
Family name *
Country of residence *
City of departure *
Phone number (with country code) *
Primary contact e-mail adress *
2. OTHER INFORMATION
Date of birth (MM/DD/YYYY) *
MM
/
DD
/
YYYY
Occupation (if applicable)
Special requirements for travels and/or during the stay:
mobility, food diets, medical, allergies,...
*
Why do you want to participate in this project? (max. 150 words)
Other information you would like to mention
3. DECLARATION
I certify that I have provided complete and accurate information and I hereby confirm my willingness and ability to attend the forenamed project's activity in its full duration.

I understand that I will be informed via email or telephone about my selection and acceptance for the project.
My acceptance is NOT automatic and needs to be done by Mladoevropani z.s.

In accordance with the law 101/2000 Act on Protection of Personal Data and under it's condition I agree that NGO Mladoevropani z.s. (based Dukelská 2531/11, 276 01, Mělník, Identification number: 142 96 080) will process my personal data for the purpose of facilitating my participation to the training. I give this permition until revocation and to the extent necessary to support the purpose of this agreement.

In accordance with the Regulation (EU) 2016/679 (General Data Protection Regulation - GDPR) and under it's condition I agree that NGO Mladoevropani z.s. and partners of this project take pictures of me during the activities and use them on their social media, website and EU portals (such as Salto Youth) to promote the project and disseminate the results of this project.
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tel.: +420 720 401 434   mladoevropani@gmail.com  fb.com/spolekmladoevropani www. mladoevropani.eu
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