Name and Surname *
Email *
Which town or village do you come from? *
Which town or village do you live now? *
Gender *
Date of Birth *
Current occupation status (student, employed, unemployed,...) *
Name of the school or employer *
Field of work or study *
Phone number *
Emergency contact - number, name, relationship (mother, father, brother,....) *
Have you ever participated in some other youth exchange or educational event abroad? *
If yes, on how many?
What is your motivation to participate in the project? (Max 100 words) *
Do you think you belong to youth with fewer opportunities - higher chance of selection (e.g. member of minority, LGBT community, from rural area, from disadvantaged background, person that face stereotypes?) *
Do you have some special needs or requests? (e.g. vegetarian food, lactose free, no pork, allergy, medical conditions etc?) If not leave empty
Are you vaccinated? (Participants will not be chosen by this matter, this information just help us to follow the procedures with traveling) *
I hereby confirm, that I give permission to organization ADEL – Association for Development, Education and Labour to process provided personal data in this form for the purposes of the selection of participants (more information: https://www.adelslovakia.org/ochrana-osobnych-udajov) *
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