Green Youth Leaders
Erasmus+: Youth, Key Action 1: Youth exchange
Venue: Berne, Bremen, Germany
Dates: 10—19 July 2023

Before filling out this application form, please read carefully all available information about this project here: https://eycb.eu/green-youth-leaders-nemecko/
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APPLICANT INFORMATION
Name *
Surname *
Gender (as written on you passport) *
Date of birth *
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Age at the time of the project: *
Citizenship *
Full address *
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) *
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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. *
Required
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: *
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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