4Safety_Registration form_Romania
Thank you for taking an interest in the 4Satety - training course -  that will take place in Romania, between 21th - 29th of May 2025.

All you need to do is to complete this form so we can find out more about you and contact you with more details about the next steps. We recommend that you read the InfoPack with attention before completing this form, and do not hesitate to contact us if you need further information.

The aim of this mobility is to teach participants how to design projects that ensure both the mental and physical safety of young people.



We are looking forward to meeting you!

____________________________

This project is implemented by A4ACTION and funded through ERASMUS+, Youth field Accreditation 2021 - 2027.

To learn more about A4ACTION, please check out our accounts on Facebook and Instagram at the following links: https://www.facebook.com/A4Action and https://www.instagram.com/_a4action/.


Sign in to Google to save your progress. Learn more
First name: *
Family name: *
Country you will represent: *
Date of birth: *
MM
/
DD
/
YYYY
Gender: *
In the country of your sending organization, you are: *
Nationality

Please note that if your nationality is different from the country of the sending organization, a proof of residence is required for participation
 *
Email address: *
Telephone: *
Organisation you represent: *
What role you have in your sending organisation *
Please tell us a bit about yourself (what you like to do, what you would like to share with us about your personality etc.): *
Please tell us about your experience in working with young people: *
What is your motivation for participating in this project? *
Have you been involved in ERASMUS+ projects before? *
What are your learning expectations from this project? *
How/where will you apply the competences (Skills, attitudes, and knowledge) developed during the project? *
Please let us know about any dietary requirements you may have (vegan, vegetarian, food intolerances, food allergies etc.). Please be as specific as you can: *
Do you have any chronic illnesses / conditions that you think we should know about? If yes, please let us know how you think we may be able to help during the project. *

Do you consider that in your life you faced at least one of the following barriers, putting you at a disadvantage compared to other persons of the same age, status, or ability:

Yes
No
Disability / special needs – e.g. mental (intellectual, cognitive, learning), physical, sensory or other disabilities
Health problems - e.g. chronic health problems, severe illnesses or psychiatric conditions
Educational difficulties - e.g. learning difficulties, early school-leaver, poor school performance
Cultural differences - e.g. immigrant, refugee or with immigrant or refugee family background, belonging to a national or ethnic minority
Economic obstacles - e.g. low standard of living, low income, dependence on social welfare system, long-term unemployment or poverty, debt or financial problems
Social obstacles - e.g. facing discrimination because of gender, ethnicity, religion, sexual orientation
Geographical obstacles - e.g. from remote or rural areas, young people living on small islands or in peripheral regions, young people from urban problem zones, young people from less serviced areas (limited public transport, poor facilities)
Clear selection
Please write down the name, email address and telephone of a person that we can contact in case of an emergency. *
GDPR (General Data Protection Regulation) - All personal data contained in this document are collected during the implementation of the Erasmus + Programme (2021-2027), in accordance with the European Commission regulations. The data will be stored and processed by the A4ACTION Association and the ANPCDEFP under the Regulation (EU) 2016/679 of the European Parliament and of the Council of 27 April 2016 on the protection of natural persons with regard to the processing of personal data and on the free movement of such data, and repealing Directive 95/46/EC (General Data Protection Regulation - GDPR). A4ACTION Association will store and process these data according to Regulation (EC) No 45/2001 of the European Parliament and of the Council of 18 December 2000 on the protection of individuals with regard to the processing of personal data by the Community institutions and bodies and on the free movement of such data. *
Required
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of A4ACTION.

Does this form look suspicious? Report

Google Forms