Application form for YE Mimicry: the roles of young generation
Dear applicant, by filling in this form you are applying for the Youth Exchange Mimicry: the roles of young generation hosted by Ostello dei Balocchi and Legambiente Ligonchio that will happen from the 4th till the 13th of December 2021 in Ligonchio (Reggio Emilia), Italy.

4th Decembrer 2021: Arrival day
5th – 12th December 2021: Program days
13th December 2021: Departure day

By filling this form you declare that you have fully read and understood the content and the conditions of the info pack of the project that you can find at this link:

Info pack Mimicry: the roles of young generation

With your application, you commit yourself to take part in the activity for its whole duration.
We will choose as participants the applicants that will look to us more in line with the aim and method of the project, the more motivated and pro-active. We recommend you to dedicate enough time and care to complete the application form fully.
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First name *
Surname *
Name you want to be called during the youth exchange *
It will be printed on your name tag
Date of birth *
MM
/
DD
/
YYYY
Place of birth *
Nationality *
Country of residence
Clear selection
Address of residence *
write the name of the STREET, NUMBER, ZIP CODE and CITY where you are officially living
Email contact *
We will communicate with you through this contact
Mobile number *
National prefix + number
What is your current occupation/profession or study? *
What is your level of English? *
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