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Application Form HOTSPOTS Connecting Suburbs through Smart Youth Work
22nd August 2023: arrival day
23rd - 28th August 2023: training (6 days of activity)
29th August 2023: departure day
La Buona Terra, Passignano sul Trasimeno (PG), Italy
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PLEASE, CONFIRM THAT YOU HAVE READ LUNARIA PRIVACY POLICY (
https://www.lunaria.org/wp-content/uploads/2018/06/privacy_gdpr-1.pdf
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SENDING ORGANIZATION:
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Country - Sending organisation
Country - Without sending organisation
FIRST NAME (complete legal name):
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Your answer
FAMILY NAME:
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E-MAIL:
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TELEPHONE (code+number, e.g. 0039 068841880):
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Your answer
RESIDENCE ADDRESS (road, number, zip code, town, country):
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Age
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Your answer
GENDER:
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Male
Female
Other
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DATE OF BIRTH:
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MM
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DD
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YYYY
PLACE OF BIRTH (town, country):
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NATIONALITY:
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SPECIAL NEED AND HEALTH REMARKS:
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DIETARY NEEDS (intolerances, restrictions, allergies):
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No extra requests
Vegan
Vegetarian
Lactose free
Gluten free
No pork
No fish
No alcohol
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EMERGENCY CONTACT (firt name, family name):
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EMERGENCY CONTACT (phone number):
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CITY OF DEPARTURE Please, specify the city, and the nearest airport, from where you will start your travel to join the project:
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CITY OF RETURN (only if different from the city of departure) Please, specify the city, and the nearest airport, where you will return after the project:
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