Into Digitization form, Erasmus+ YE

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We are happy you have decided to participate in our Youth Exchange. Please will the form thoroughly. We will assess each participant and select those for whom we'll find the project will bring the most value :)

Email *

Personal Information

City of residence
*

Nationality
*

First name
*

Last name
*

Gender
*

Male

Female

Prefer not to say

Other:

Date of birth
*

YYYY

Occupation / Work *

Mobile number (with country code) *

WhatsApp number (with country code) *

Please write 'I don't have' if you don't have WhatsApp

Emergency contact *

Full name, relation, mobile number (with country code)

Link to your Facebook page
*

Please write 'I don't have' if you don't have a FB page

Project related details

How many E+ Youth Exchanges have you participated in? *

Do you have any special needs, diets, allergies, health conditions, etc.? *

Yes

If 'Yes', please describe them in detail

Why do you want to participate in this project? *

How would you describe your social skills and communication abilities?
*

Are you considered to be in any of the 'fewer opportunities' category below? *

Economic: unemployed, low standard of living, low income, dependence on social welfare system, in debt or with financial problems.

Social: facing discrimination because of gender, ethnicity, religion, sexual orientation, disability, etc., limited social skills or anti-social or risky sexual behaviours, in a precarious situation, (ex)offenders, (ex)drug or alcohol abusers, young and/or single parents; orphans, young people from broken families.

Disability: mental (intellectual, cognitive, learning), physical, sensory, or other disabilities.

Educational difficulties: with learning difficulties, early school-leavers and school dropouts, lower qualified persons, with poor school performance.

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

Health problems: chronic health problems, severe illnesses or psychiatric conditions, with mental health problems.

Geographical obstacles: from remote or rural areas, living on small islands or peripheral regions, from urban problem zones, from less serviced areas (limited public transport, poor facilities, abandoned villages).

No, I am not

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I agree

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You must confirm that you read the Infopack, are fully aware of its content, and agree to the Terms & Conditions listed in it. *

Note, this participant form should only be accessed from the InfoPack. Link to the InfoPack:
https://drive.google.com/file/d/1Kcd9AlTHI3Dmp_WAs1WAQZD2d5-hAd1U/view?usp=sharing

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We may contact you in the future regarding projects and activities that might be of interest (optional) :)

I agree

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