A Path Together - Youth Exchange - Application Form
Dear applicant, by filling in this form you are applying for the youth exchange  "A Pass Together" that will happen from the 18th - 26th October 2022 (18th October 2022 Arrival Day, and 26th October 2022 Departure Day) in Otranto, Italy.

By filling this form you declare that you have fully read and understood the content and the conditions of the info pack of the project:

https://thenewellnessacade.wixsite.com/apathtogether

With your application, you commit yourself to take part in the 3 phases of the exchange: preparation, youth exchange and post-exchange part.

We will choose as participants the applicants that will look to us more in line with the aim and method of the project, the more motivated and pro-active. We recommend you to dedicate enough time and care to complete the application form fully and to communicate to us why it's important for you to get involved.

Deadline for applications: ASAP
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Email *
Current country of residence *
Select the place where you are officially resident. In case it is different from the place where you are living, specify it in the "notes" at the bottom of this application form
Are you applying as a Participant or as a National Group Leader? *
Group Leaders will coordinate their national group during the preparation and follow-up phases and support the coordinators during the exchange with practical tasks and sharing moments    
Name *
Surname *
Date of Birth *
MM
/
DD
/
YYYY
City of Birth *
Country of Birth *
Phone Number including country code *
We will communicate with you through this contact
Your e-mail *
We will communicate with you through this contact
In case you need a passport to travel to Italy, write here the expiration date *
ID/Passport number number *
Address (Street, Number, City, Postal Code) *
Do you have a medical insurance valid in Italy? *
ex. the European Health Card
European Health Insurance Card (EHIC) number
Your age at the beginning of the youth exchange *
How do you identify yourself concerning your gender? *
Providing only "female" and "male" as options may be limiting for somebody
Level of English *
Contact in case of emergency (Name, Surname, Phone Number, Relation to you) *
If selected, from which city would you be travelling to Otranto for "A Path Together"? *
What is your current occupation or profession? *
Choose your sleeping option *
Tents, pillows and sleeping bags are  provided by us
Required
Are you vaccinated against Covid-19? *
What vaccine did you take? How many doses? Write the date of the last injections *
Ex: Pfizer-Biontech, 3 dosis, 3rd dosis made on 21st April 2022
How did you find out about this project? *
Facebook/web page/newsletter of my sending organization; on a group related to international mobility (write the name), on a youth mobility portal (write the name), in a youth centre, from my friend John Brown; Mary Smith recommended it to me etc.
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