DiCreNDi: Application Form

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Training course
Cluj-Napoca - Romania
August 23-29, 2021 (travel days included)
Project webpage: https://dicrendi.eu/
Info pack: https://babilontravel.eu/wp-content/uploads/2021/07/DiCreNDi-A1-Info-pack-for-applicants.pdf

Please fill out the form using ONLY the Latin alphabet, without diacritics. Fields marked with * are mandatory.

First name: *

Last (Family) name: *

Gender *

Female

Male

Prefer not to say

Date of birth: *

YYYY

City of birth: *

Country of birth: *

City of residence *

Country of residence: *

E-mail address: *

Phone number (please include country code, e.g. +40722...): *

Your level of English: *

The document you will use during the journey to Albania

Poor

Basic

Good

Very good

Fluent

How many Erasmus+ projects did you attend? *

None

1-3

4-10

More than 10

You apply as participant of: *

Ikkaido Inclusive Martial Arts – Ireland;

Projekte Vullnetare Nderkombetare – Albania

Mreza za Dozivotno Ucenje - North Macedonia

Polski Zwiazek Niewidomych – Poland

Liceul Special pentru Deficienti de Vedere Cluj-Napoca – Romania.

Asociatia Babilon Travel - Romania

You apply as a:

Youth worker of the sending organization, age 18+

Visually impaired/blind youth worker of the sending organisation, age 18+

Accompanying person, age 18+

Clear selection

What is your experience in working with young people? *

What is your motivation to participate to this training course? *

In case of an emergency, who should we contact on your behalf? *

Do you have any special needs, dietary requirements, allergies or anything else that the host organisation should know about? *

Regarding COVID-19 vaccination, are you already vaccinated?

Yes

No, but I will finalize the vaccination process at least 14 days before starting the journy to Cluj-Napoca, Romania (August 23, 2022)

No, I am not vaccinated, but I agree to make the COVID PCR test within maximum 48 hours before starting the journey to Cluj-Napoca (August 23, 2021), on my own cost, that will not be reimbursed

I comply with all the rules regarding internatiol traveling, including COVID-19 restriction.

In case you would like to add something, here is the right place: *

Conditions of Participation: *

I read, understood and agree with the entire info pack for applicants.

I will commit myself to participate to all activities, including preparation meetings and dissemination, as described in the info pack;

I confirm that I will arrange and pay for my own travel expenses, but that these costs will be reimbursed to me, up to set limits, after my successful attendance of the activities, as described in the Info Pack;

I understand that I am responsible for obtaining my own health insurance and in case of need, to do the PCR/antigen COVID-19 tests, and that these costs are NOT covered by the project and are NOT REIMBURSABLE;

I agree that submitting information to you about my special needs does not remove my own personal responsibility for ensuring my own health and safety;

I authorize the host organization and its partners to publish (in whatever form and by whatever medium they choose, pictures, videos, etc.) information about the activities, results and my participation therein.

Required

Data Protection (GDPR) *

In compliance with the GDPR I hereby authorize you to use and process my personal details contained in this document which will not be used for commercial purposes.

Required

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