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& 0 0 0 0 5 5 5 ( ( ( ( ( ( ( $ * {- F @( 5 " 5 5 5 @( 0 0 U( ' ' ' 5 0 0 ( ' 5 ( ' ' \" " 0 Y t" ( k( 0 ( |" - i - " " ^ - ' $ 5 5 ' 5 5 5 5 5 @( @( ' 5 5 5 ( 5 5 5 5 - 5 5 5 5 5 5 5 5 5 : Participant Application form for "For-Ex"
This participants form is to apply to become a participant of "For-Ex" Training Course under the Erasmus + KA1 Mobility of Youth Workers, which will be held in Sinop, Turkey. Arrival Day: 9 February 2015 - Departure Day: 15 February 2015 Travel will be reimbursed according to the Erasmus+ grant. Travel grant per participant is 275 Euros. If your travel is greater, participant and/or organisation will be in charge of covering the difference.
* Required
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Name:
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Surname:
PRIVATE "" MACROBUTTON HTMLDirect
Gender:
E-mail:
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Date of Birth:
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Place of Birth:
Town, Country
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Address:
Address of residence and country
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Mobile Phone:
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Proficiency of English: Fluent, Intermediate, Basic
Special Needs or Requirements:
Please let us know if you require any special arrangements or if there are things we need to be aware of (vegetarian, allergies, impediments,)
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Please indicate the name and full contact details of a person to be contacted in case of emergency during the Training:
Name, phone, email address
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The name of your organization: Association for Progress, Education and Lobbying PEL
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The address of your organization: ul. Dimo Hadzi Dimov 54b, 1000, Skopje, Macedonia
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The email of your organization: HYPERLINK "mailto:pel_youth@yahoo.com" pel_youth@yahoo.com, HYPERLINK "mailto:contact@pel.mk" contact@pel.mk
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In how many youth exchanges have you been a leader?
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Additional Comments:
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What is your experience with Youth Exchanges?
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Please take note of the following conditions that will apply if you are selected to take part in the project:
I commit myself to participate in the whole process, including: to prepare myself carefully for the Seminar and to do all remote preparation work the team will ask for, to take part in the full duration of the project to participate in the whole evaluation process I am aware that obtaining a health and a full travel insurance, is my own responsibility and at my own expenses. I understand that the information I provided on my special needs does not remove my own personal responsibility for ensuring my own health. I understand and agree that the training may be photographed / videoed and used on for publications or websites.
PRIVATE "" MACROBUTTON HTMLDirect I agree
I will take responsibility for completing the questionnaire exploring conflict situations based on cultural diversity in Youth Exchanges experienced by your organisation.
PRIVATE "" MACROBUTTON HTMLDirect I agree
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