Game Changers

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Game Changers

Erasmus+: Youth, Key Action 1: Training Course
Venue: Gravina in Puglia (Italy)
Dates: 26—31 May 2023

Before filling out this application form, please read carefully all available information about this project here: https://eycb.eu/game-changers-italie/

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APPLICANT INFORMATION

Name *

Surname *

Gender *

Date of birth *

YYYY

Age at the time of the project: *

Citizenship *

Town/city (where you live) *

Current country of residence *

Region: *

Email address *

Mobile phone number *

Link to your social media profile *

Where/how did you find out about this project? *

Passport expiry date (if you do not own a passport, please do NOT apply for this project) *

YYYY

Does any of these apply to you? *We wish to give equal opportunities to everyone. If you face any obstacles, please indicate, so we can also ensure diversity in our group. *

You face geographical obstacles: You live in rural area (countryside), dangerous area in city or in any other way face geographical obstacles

You face cultural differences: You are minority, immigrant/refugee or descendant from immigrant or refugee families. This includes young people belonging to a national/ethnic minority.

You face economic obstacles: You are unemployed or struggle with your finances (low income). You may be dependent on social welfare system.

You are not in education/employment or training (NEET)

You have a disability/special needs: you are a young person with mental (intellectual, cognitive, learning), physical, sensory or other disabilities

You have a health problem: you are a young person with chronic health problems, severe illnesses or psychiatric conditions

You face social obstacles: You are a young person facing discrimination because of gender, age, ethnicity, religion, sexual orientation, disability, etc.

You face educational difficulties: You may be a young person with learning difficulties, an early school leaver, a young person with poor school performance

None of the above

기타:

필수

Do you have any special needs or requirements that the host organization should know about? (E.g.mobility, medical needs, allergies, dietary restrictions such as vegan) *

Please provide us with an emergency contact details (name & surname, email address, phone number, languages they speak) *

Please let us know your vaccination status against Covid-19 will be by the the start of this training course: *

I will hold a valid Covid-19 certificate at the time of this project

I will NOT have a valid Covid-19 certificate

I do not intend to be vaccinated

I have recovered from Covid-19 disease (and I have a certificate proving so). It will have been fewer than 180 days since my first positive Covid-19 PCR test and the end of this project. I will hold a valid Covid-19 certificate at the start of this project.

기타:

Language abilities in English *

A1 (Beginner)

A2 (Elementary)

B1 (Intermediate)

B2 (Upper-Intermediate)

C1 (Advanced)

C2 (Proficiency)

Listening

Speaking

Reading

Writing

ORGANIZATION INFORMATION: Please tell us about your ORGANIZATION, i.e., the (non-profit non-governmental) organization that you actively work/volunteer for, IF ANY). Please leave BLANK (empty) if you are NOT active in any non-profit non-governmental body]:

Name of organization

Address

Website

What are your roles (volunteer, youth worker, board member, director ...) and your tasks? Please tell us how long you have been involved in youth work?

Please describe your organization briefly. What are the objectives, main activities and target group of your organization?

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