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Queer Circus: training course against gender and sexual orientation discrimination
Circus Pedagogy project as a tool for youth work against gender discrimination
Erasmus+: Youth, Key Action 1: training course
Venue: Palazzo Ulmo, Taranto, Italy
Dates: 25 May
—2 June
2024
Before filling out this application, please read carefully all information about this project here:
https://eycb.eu/
lgbtqi-italie
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APPLICANT INFORMATION
Name
*
Tu respuesta
Surname
*
Tu respuesta
Sex (as written on you passport)
*
Elige
Female
Male
Gender that you identify as:
Tu respuesta
Date of birth
*
DD
/
MM
/
AAAA
Age at the time of the project:
*
Tu respuesta
Citizenship
*
Elige
Czech
Slovak and I DO have a valid residency permit in the Czech Republic
Slovak but I do NOT have a valid residency permit in the Czech Republic
Other and I do have a valid residency permit in the Czech Republic
Other and I do NOT have a valid residency permit in the Czech Republic
I am a Ukrainian citizen and I have been granted temporary protection in the Czech Republic
City/town (where you live):
*
Tu respuesta
Current country of residence
*
Tu respuesta
Region:
*
Elige
Hl. město Praha
Středočeský
Jihočeský
Plzeňský
Karlovarský
Ústecký
Liberecký
Královéhradecký
Pardubický
Kraj Vysočina
Jihomoravský
Olomoucký
Moravskoslezký
Zlínský
Not applicable, I do not live in the Czech Republic
Email address
*
Tu respuesta
Mobile phone number
*
Tu respuesta
Link to your Instagram profile:
*
Tu respuesta
Link to your Facebook profile:
*
Tu respuesta
Where/how did you find out about this project?
*
Tu respuesta
Passport expiry date (if you do not own a passport, please do NOT apply for this project)
*
DD
/
MM
/
AAAA
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
Otro:
Obligatorio
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)
*
Tu respuesta
Please provide us with an emergency contact details (name & surname, email address, phone number, languages they speak)
*
Tu respuesta
Language abilities in English
*
A1 (Beginner)
A2 (Elementary)
B1 (Intermediate)
B2 (Upper-Intermediate)
C1 (Advanced)
C2 (Proficiency)
Listening
Speaking
Reading
Writing
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
Tu respuesta
Address
Tu respuesta
Website
Tu respuesta
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?
Tu respuesta
Please describe your organization briefly. What are the objectives, main activities and target group of your organization?
Tu respuesta
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