HOPE - Protecting Mental Health

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Erasmus+: Youth, Key Action 1: Youth exchange
Venue: Varna, Bulgaria
Dates: 26 May—5 June 2023

Before filling out this application form, please read CAREFULLY all of the information about this project on our website: https://eycb.eu/hope-bulharsko/

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APPLICANT INFORMATION

Name *

Surname *

Gender (as written on you passport) *

Date of birth *

YYYY

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) *

YYYY

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. *

You face geographical obstacles: You live in rural area (countryside), dangerous area in city or in any other way face geographical obstacles

You face cultural differences: You are minority, immigrant/refugee or descendant from immigrant or refugee families. This includes young people belonging to a national/ethnic minority.

You face economic obstacles: You are unemployed or struggle with your finances (low income). You may be dependent on social welfare system.

You are not in education/employment or training (NEET)

You have a disability/special needs: you are a young person with mental (intellectual, cognitive, learning), physical, sensory or other disabilities

You have a health problem: you are a young person with chronic health problems, severe illnesses or psychiatric conditions

You face social obstacles: You are a young person facing discrimination because of gender, age, ethnicity, religion, sexual orientation, disability, etc.

You face educational difficulties: You may be a young person with learning difficulties, an early school leaver, a young person with poor school performance

None of the above

其他：

必填

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) *

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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