Create your future - Application form
Dear applicant,

by filling in this form you are applying for the youth exchange "Create your future" which is going to happen from June 27 till July 4, 2021 in Ravnogor, Bulgaria (excluding travel days).

The project is open for participants from 18 till 25 years old resident in Bulgaria, Poland, Croatia, Italy, Greece and Spain.

With your application you commit yourself for the whole duration of the project: preparation, participation in the exchange and follow-up activities.

Kind wishes,
Synergy Bulgaria team
Sign in to Google to save your progress. Learn more
Country of residence: *
What role are you applying for? *
First name: *
Last name: *
Name you want to be called during the project (this will be printed on your name tag) *
How do you identify yourself regarding your gender? *
Date of birth *
MM
/
DD
/
YYYY
Place of birth *
Address of residence 1 (street/square name and number) *
Address of residence 2 (ZIP code and city) *
Email contact *
Mobile number (national prefix + number) *
What is your current occupation or profession? *
What is your level of English? *
Do you have any physical limitation? If yes, please explain what it is and how it is limiting you: what you can and what you can't do.
Do you have any diet or allergy? (e.g. vegan, vegetarian, lactose free, gluten free, allergy to cheese etc.)
Do you take any regular medication? Please write here all the medication names you take.
Do you have a medical insurance valid in Bulgaria? (e.g. the European Health Card) *
Contact in case of emergency (write the name, surname, phone number and relation of this person to you). *
Did/do you face any obstacle/difficulty related with your social environment, culture, identity, family, economical situation or do you live in an isolated place? Do you have chronic health problems? Please explain briefly.
What are the reasons that bring you to apply for this project? *
What do you want to improve or learn concerning your personal development during 'Create your future'? *
What challenges (obstacles, life questions, important decisions, struggles) do you experience in life at the moment? How do you deal with them? *
How did you find this project? (Facebook, friends, someone recommended it to me etc.) *
If there is anything you would like to add, you can do it here:
Declaration
By submitting this application form I declare that all the above information are true and correct to the best of my knowledge. I confirm that I have read and understood the information written in the infoletter of the project and the conditions of reimbursement of 'Create your future' project. I know and accept the conditions of participation. I commit myself to take part in the full duration of the project: preparation, international program and follow-up activities and to participate in the whole evaluation process. In case I break this commitment, I will renounce the travel reimbursement. I am aware that obtaining a health and a full travel insurance is my own responsibility and at my own expenses. I understand that the information I provided on my special needs does not remove my own personal responsibility for ensuring my own health. I understand and agree that the project may be photographed/filmed and used for publications or websites and social networks to provide visibility to the project, the organizations and the public bodies involved in it.
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms