Volunteering in Rouillon, France

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Name and Surname *

Age (DD/MM/YYYY) *

Gender *

Male

Female

Others

Phone number *

Do you have WhatsAPP/Viber/Imessage? *

E-mail *

Your Facebook/Linkedin/Instagram/ link: *

Organization/if applicable/

Where and what do you study? *

If no, what is your current occupation?/if applicable/

Where do you live now? Full address: Street, city, country *

Are you coming as a Participant or as a Group Leader?

Group Leader

Participant

Clear selection

Motivation and Expectations *

What’s your motivation to participate in this project? What would you like to learn, gain, understand and experience during it?

Health information *

Please send us all relevant information concerning your health or any special needs or requirements (allergies, intolerances, mobility, medical needs, allergies, dietary restrictions, smoker/non-smoker , etc …)

What is your English language level: *

Poor

Basic

Intermediate

Advanced

Fluent

In how many Erasmus + projects have you participated? *

1-3

4-6

7-9

10 or more

Are you coming from a disadvantaged background /family in difficulty? *

Young people with fewer opportunities are given priority to go to youth projects in Europe (confirmation / proof required).

Yes

If yes, please explain:

Do you have Health European Card that is valid for the period of the Youth Exchange? *

Yes

My HEC is expired, but I will renew it before my travelling?

Covid-19 Measures

What is your past experience with COVID-19 *

I have a positive PCR test in the last 180days before starting the YE?

I will be vaccinated with 2nd dose 14 days before traveling for the YE?

I will make a Negative PCR test 72 hours before entering or Negative Antigen test 48 hours before entering or

Agreement *

By submitting this application I confirm that I have read and understood the Information provided and the conditions of travel reimbursements about the project and I know and accept the conditions of participation.

I confirm

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