Balance - Youth Exchange

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This is the registration form for the Balance program, funded by Erasmus +.
For more info, click here: https://www.czechinspire.eu/balance/

Email *

First name *

Family name *

Gender *

They are asking us this question in the Erasmus Mobility tool, we need to know what you want us to put there.

Man

Woman

Other

Prefer not to say

Your country of residence *

Date of birth *

YYYY

Do you consider yourself a young adult with fewer opportunities? *

Erasmus+ defines fewer opportunities as following. Even if you don't find yourself in any of those categories, but you recognize yourself as with fewer opportunities, please, let us know: https://www.salto-youth.net/rc/inclusion/archive/archive-resources/inclusiongroups/inclusionoffenders/InclusionOffendersWho/

Social obstacles

Economic obstacles

Disability

Educational difficulties

Cultural differencies

Health problems

Geographical obstacles

Other:

Why would you like to participate in Balance program? *

What is regularly taking you out of balance in your life? *

Describe your relationship with movement in a few words. *

This can be anything from being primabalerina through just enjoying walking to school to no movement in my life.

How would you like to contribute to the program? *

If you have a special activity you would like to implement, let us know.

I am applying as a... *

participant only

group leader only

I can be both

Other:

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