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VIRTUAL INSANITY ||| GREECE, 2013 ||| IDENTIFICATION OF PARTNER PROMOTER
Dear prospective partners, it is mandatory to DULY, CORRECTLY AND COMPLETELY fill in this form, as these are the data required by the donors. The deadline is April 25nd!
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PROMOTER
promoter's legal name (in national language)
Your answer
promoter's legal name (latin characters)
*
Your answer
acronym, if applicable
Your answer
National ID number, if applicable
Your answer
department, if applicable
Your answer
legal address
*
Your answer
postal code
*
Your answer
city
*
Your answer
country
*
Your answer
region
*
Your answer
website
Your answer
e-mail
*
Your answer
telephone
*
Your answer
fax
Your answer
Person authorised to legally commit the promoter (legal representative)
title
Your answer
family name
*
Your answer
first name
*
Your answer
position
*
Your answer
e-mail
*
Your answer
ONLY IF DIFFERENT FROM ABOVE: legal address
*
pls indicate legal address, postal code, city, country, region
Your answer
telephone
Your answer
fax
Your answer
Person responsible for the implementation of the action (contact person)
title
Your answer
family name
*
Your answer
first name
*
Your answer
position
*
Your answer
e-mail
*
Your answer
ONLY IF DIFFERENT FROM ABOVE: legal address
*
pls indicate legal address, postal code, city, country, region
Your answer
telephone
Your answer
fax
Your answer
PROFILE OF THE PROMOTER
status and type
*
private: non profit / non governmental
private: body active at European level in the youth field
private: informal group of young people
public: public body
activity level
*
local
regional
national
European
international
objectives and activities of the promoter
*
Please provide a short presentation of your organisation/group (usual activities, affiliations, etc) in relation to the field covered by the project.
Your answer
other community funding
Please give information about any type of Community grant your organisation/group has received/ applied for in the last financial year. Indicate: 1) which programme or initiative, 2) identification or contract number, 3) contracting promoter, and 4) title of the project
Your answer
MOTIVATION, CONDITIONS AND CONTRIBUTIONS
the information in this section is very important in order to design the project based on your needs, and to help us in the selection of partner promoters
Do you already have specific participant(s) in mind for this training course?
If yes, then please indicate name, age, gender and position in your organisation
Your answer
Needs, expectations and contributions
*
Please give us an idea of your needs and expectations towards this training course, of your potential contributions to it, and how your participation in this training course will be beneficial for you, for the other partner organisations and participants, for your organisation, and for the young people are working for. Please make SPECIFIC REFERENCE to the topic of the training course!
Your answer
special needs
As far as you can tell as this point of time, will your particpant(s) have special needs?
Your answer
visa and travel costs
*
Please indicate an estimation of your expected travel from your home town to the venue of the training course (Crete in Greece). Only cheapest means of transport are eligible. If applicable, please also indicate costs for visa.
Your answer
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