"Embracing trust" application form

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Dear applicant,

by filling in this form you are applying for a training course "Embracing trust" that will happen °17 - 28.3. 2017 in Adamov, Czech Republic. You need to be able to participate in the whole project.

The project is open for participants from the Czech Republic, Hungary, Italy, Spain, Greece, Romania, Croatia and Bulgaria.

With your application, you commit yourself for the whole project: preparation, participation in the project, dissemination and follow-up activities.

We need the following data to prepare everything by the time you arrive. We ask you to give correct and valid data. Some questions are there for you to reflect on yourself, as it will be a lot about personal development.

The participants will be selected based on the quality of application forms so we recommend you take time to fill it in carefully.

See you soon,

Brno Connected team

Personal information

First name: *

Last name: *

Name you want to be called during the project: *

Gender *

male

female

Date of birth: *

YYYY

Address: *

(street and number)

ZIP code *

City: *

Country: *

E-mail address: *

Phone number: *

Don´t foget your national pre-fix

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