Application for "Communication: Agent of Change"

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Dear applicant,

by filling in this form you are applying for a two-phase training of Nonviolent communication called "Communication: Agent of Change" happening 14.-20.8. and 13.-19.10.2019 in the ecocentre Oldřichov v Hájích, the Czech Republic.

We ask you to fill in the application only if you are committed and able to participate fully if selected. You need to be able to participate in the whole project, meaning in both trainings, preparation, training, dissemination and follow-up activities, and evaluation.

The project is open for participants from the Czech Republic, Italy, Greece, Bulgaria, Romania, Hungary, the Netherlands, Spain (either of this nationality of currently living in one of these countries).

The participants will be selected based on the quality of application forms, therefore we recommend you to take time to fill it in carefully. We ask you to give correct and valid data.

NVC Brno team

Personal data protection info:
We are going to dispose with information you provided with respect and according to General Data Protection Regulation (GDPR) and we will be using them only for the purposes of "Communication: Agent of Change" project. Data from the application are accessible to the team of the project and applications will be shared with the partner organisations in order to make the selection of applicants. Only applications from a given country will be shared with a given organisation (I.e. Spanish applications will be shared to the Spanish organisation, etc.)
At the end of this application, we will ask you to give us permission to keep your data - without this we are not able to process your application for the project.

Personal information

Country of residence: *

Czech Republic

Bulgaria

Greece

Italy

Romania

Hungary

Spain

the Netherlands

Other:

First name: *

Last name: *

Name you want to be called during the project: *

Gender *

male

female

Other:

Date of birth: *

YYYY

Age at the beginning of the project: *

Nationality: *

E-mail address: *

Phone number: *

Don´t foget your national pre-fix

Address: *

Street, number, zip code, city, country

What is your level of English? *

excellent

good

medium

basic

What is your current occupation or profession? *

We would like to know what you do, as well as your link to youth work/social work/work with people - for example: if you have a full-time job + you volunteer in an NGO, describe your role and involvement there as well.

Do you belong to some of the fewer opportunities groups?

Please check following link and then tick if you are fitting to any of these groups: https://www.salto-youth.net/tools/otlas-partner-finding/help/young-people-with-fewer-opportunities/. We are asking about this because we want to give priority to people who are facing conditions that might make their participation in a commercial training of this kind difficult. However, it is not the only selection criteria.

Economic obstacles (unemployed, low income, dependence on social welfare system, with financial problems, etc.)

Social obstacles (facing discrimination because of gender, age, ethnicity, religion, sexual orientation, disability, etc.)

Disability (mental, physical, sensory or other disabilities, etc)

Health problems (chronic health problems, severe illnesses or psychiatric conditions, etc.)

Educational difficulties (people with learning difficulties, early school leavers, lower qualified persons, etc.)

Cultural differences (immigrants, refugees or descendants from immigrant or refugee families; belonging to a national or ethnic minority; people with linguistic adaptation and cultural inclusion difficulties, etc.)

Geographical obstacles (from remote or rural areas, living on small islands or in peripheral regions, from urban problem zones, from less serviced areas (limited public transport, poor facilities), etc.)

Other:

If you marked some of the boxes in the previous section, please specify:

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms