EnCourage 3 - Application Form

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EnCourage 3 - Application Form

You are applying for the "EnCourage 3" Youth Exchange that will take place in NaturKultur, near Bremen in Germany. Read carefully all the questions and take your time to answer them in detail. The project is open for participants from Germany, Greece, Portugal, Latvia, Czech Republic, Serbia, Romania and Poland.

End of application is 24.03.2023. If you apply after this date you will be on the waiting list and contacted in case there are open spots available.

Here are the dates:

Activity: Youth Exchange
Arrival day: 23rd April 2023 (21st April for Group Leaders)
Departure day: 4th May 2023

Before applying, we kindly ask you to read our info website (https://www.encourageproject.org/encourage3) and in case you have any questions, please do not hesitate in contacting us at navigaia.encourage.project@gmail.com. With your application, you commit yourself to take part in the 3 phases of the exchange: preparation, youth exchange and post-exchange part. Do not buy tickets before an official confirmation from us. Details on booking the tickets will come with a confirmation email on the 27th of March 2023.

This sign up form consists of three parts:
1. Personal details
2. Experience, Motivation and Desired Outcomes
3. Commitment and Declaration

Filling in the form will take you approximately 10 to 15 minutes depending on your answers.

Email *

Are you applying as a Participant? *

As a participant you take part in the Youth Exchange, the dissemination and follow-up activities. If you have further questions feel free to drop us an email at navigaia.encourage.project@gmail.com

Participant

First Name *

Surname *

Name you want to be called in the project *

Take in consideration that this will be the name by which you will be addressed during the project and that will appear on your name tag.

Gender *

We ask this in order to achieve gender balance required by Erasmus+ programme.

Female

Male

Other:

Date of birth *

YYYY

Age at the beginning of the project *

Nationality *

Country of residence *

Only participants living or with a residency from this countries are eligible for this project.

Germany

Portugal

Latvia

Czech Republic

Greece

Serbia

Poland

Romania

Full address *

Address where you are officially registered. Street, postcode, city, country

Phone number *

Including the international code

Facebook profile link address

We will use this link in case you are selected to add you to the private Facebook group of the EnCourage project.

Level of English *

Fluent

Good

Medium

Low

Occupation/Profession *

Contribution fee

Is the contribution of 30€ an obstacle for you to participate in the project? If yes, how can you contribute to the project instead? Your answer will not influence your selection in the project.

My current physical health condition is... *

Please describe your current physical health so that we can adapt the program accordingly. This is a training that is based on physical activities and movement, therefore we need to know if you have any health problems that could affect your participation in this project. We wish to create an experience where everyone can be involved and this information will help us to adjust the program to your needs.

My mental health condition is... *

To be explained.

Do you have a medical insurance valid in Germany? *

e.g. European Health Insurance EHIC

Yes

No, but I declare I will have one before coming to Germany

Do you agree to a vegetarian diet during the project? *

In this training course, the meals provided will be (delicious) vegetarian. If spending this time without eating meat or fish is a problem for you, please let us know.

Yes

Do you have any medical food allergies or intolerances? *

Please let us know if you have any severe food allergies or intolerances. Also let us know how you react to these allergies and how we should react in case you have an allergic reaction (do you use any medication that we need to know for example).

Do you have any other specific diet?

Please be aware that we can not take into consideration personal preferences of taste for particular ingredients. If you have a medical condition please indicate this above.

Vegan

Gluten Free

Lactose Intolerant

Other:

Clear selection

Contact person in case of emergency *

Full name, address, e-mail, phone number incl country code, relationship with you. By sharing this information you declare that this person has been informed about being your contact person.

What fewer opportunities are you facing? Mark the boxes that apply to you *

In the link: https://docs.google.com/document/d/1bywy6knQDD5jTtlAGWN_rwVDl5Iku5sqMUybHxsSoE8/edit you'll find a specific description of the types of fewer opportunities that the European Commission considers. Read it carefully as the spots are reserved for participants with fewer opportunities.

None

Social obstacles (young people facing discrimination, young people with limited social skills or anti-social or risky sexual behaviours, young people in a precarious situation, (ex) offenders, (ex) drug addicts, young and/or single parents, orphans, young people from broken families, etc.

Economic obstacles (young people with a low standard of living, low income, dependence on social welfare system, long-term unemployed youth, homeless young people, young people in debt or in financial problems, etc.

Educational difficulties (young people with learning difficulties, early school-leavers and school dropouts, lowly or non-qualified persons, young people that didn't find their way in the school system, young people with poor school performance, etc.)

Cultural differences (young immigrants or refugees or descendants from immigrant or refugee families, young people belonging to a national or ethnic minority, young people with linguistic adaptation and cultural inclusion problems, etc.)

Geographical obstacles (young people from remote, rural or hilly areas, young people living on small islands or peripheral regions, young people from urban problem zones, young people from less serviced areas, etc.

Disability (young people with mental (intellectual, cognitive, learning), physical, sensory or other disabilities)

Health problems (young people with chronic health problems, severe illnesses or psychiatric conditions, young people with mental health problems, etc.)

Required

Can you spare some time and energy to help us clean after the project? *

We need some more hands to clean the venue on the departure day (4th May) for some more hours in the afternoon.

Yes

I have to check my departure options first

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