Application form [V4 4 Easter]



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Data01.05.2016
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Application form

[V4 4 Easter]

[Youth Exchange]

[Wodzislaw Slaski, Poland]



[13-21 March 2016]


Name:




Surname:




Address:




City:




Occupation:




Country:




Date of birth:




Tel:




E-mail:




Gender: (M/F)




Special needs:




Vegetarian (yes/no):




Language skills:




What is your motivation to take part in this project?




Do you have some experience with international youth exchanges ?




What are your expectations towards this project?




How do you want to use gained skills and knowledge after this project?



How did you know about our organization and the project?



I confirm, that I will be in this project during the whole event.




Wyrażam zgodę na przetwarzanie moich danych osobowych zawartych w tym formularzu dla potrzeb niezbędnych do realizacji procesu rekrutacji (zgodnie z Ustawą z dnia 29.08.97 o ochronie danych osobowych, Dziennik Ustaw Nr 133 Poz. 883)

I agree to use my personal data for the purposes of the application process of the project (accordingly to Polish act of law from 29th August 1997 about the security of personal data)

TAK/yes NIE/no

Uwaga: Informacja! Podczas projektu będą powstawały zdjęcia i materiały multimedialne, które partnerzy projektu mogą używać w social mediach i na stronach www. Jadąc na projekt zgadzasz się na to.

Attention! During the project there will be video and photo materials taken, which will be used afterwards to promote the project. Taking part in the youth exchange you accept the use of materials with your person on them.



Date:




SIGN / Name and surname:




Thank you for the time which you spend by fulfilling this form.

Please, send this form until 5th March 2016



to: wojtek.frydrych@unescocentre.pl









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