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Social Entrepreneurship, The New Era
Cyprus
19th 26th of October 2021
(Arrival 18/10-Departure 27/10 )
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Name
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Surname
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Date of Birth
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Address of Residence
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Country of Residence
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Nationality
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Gender
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Female
Male
Email Address
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Telephone number (with country code)
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Contact person in case of Emergency
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Please provide the full name of a person that we can contact with in case of emergency as well as a phone number and a valid e-mail address
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Are you Fully Vaccinated?
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YES
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Other:
Did you had Covid-19 the last 6 months?
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YES
NO
If Yes When?
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Sending Organisation
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Do you have a special diet?
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Vegetarian, vegan, food allergies, do you eat fish, etc?
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What is your present health condition?
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If you have any health situations the we need to take in account during the project, please descried including the use of medication. (allergies, health problems etc)
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Do you have medical insurance valid in Europe?
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What is your current status?
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Student, Unemployed, Employed , free lancer etc.
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Educational Background
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Have you participated in any other Erasmus+ project? If yes give us more details.
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What is your motivation to participate in this project?
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How can you contribute in this project? ( take photos, video editing, know energizers, first aid, organizational skills if any etc)
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Do you belong in fewer opportunities category?
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Economical Obstacles ( unemployed etc)
Geographical Obstacles (live in rural areas, island etc)
Social Obstacles
Migrant or asylum seeker
None
Other:
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