Application form - Cyber equality youth exchange in Croatia
Dear Applicant!

Thanks for being interested in this project. If you aret thinking about joining us in Samobor for youth exchange Cyber equality, we kindly ask you till in this form. Your personal data is in good hands. We are not going to give it to anybody else. Your data will be used for the project Cyber equality purposes only (applications, mobility, report, dissemination).

Here you can read the Ordinance Personal Data Protection: https://tinyurl.com/y6cduelp 

This is the Application Form of Cyber equality.

APPLICATION DEADLINE: 25 July 2019
Date: 2nd September - 8th September, 2019
Place: Samobor, Croatia

With any questions please contact me  on marijana.janjic@lagsava.hr, 00385 95 386 2246
or
the possible sending organization you belong to.


Organizer: LAG SAVA, Croatia, www.cyberakademija.com


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Email *
Forename *
Family name *
E-mail *
Official address (street name and number, city, postal code, country): *
Travel document type: *
Nationality *
Number of your travel document: *
Phone number (with country prefix): *
Gender *
Date and place of birth *
Mother's maiden (full) name: *
Occupation or profession: *
If you have any special diet or allergy regarding the food please mark here: *
Required
Detail any health problems (including surgery) you may have and their present state. Specify and describe any medication you take or took within the last 6 months. *
Contact person in case of emergency (full name, address; phone numbers; their relationship to you): *
Level of English in speaking: *
Name of sending organization *
What is gender equality for you? *
What is your personal goal with participating in this course? *
You agree that your personal data can be collected and analyzed for the purposes of Cyber equality project according to the Ordinance Personal Data Protection by LAG SAVA (online source: https://tinyurl.com/y6cduelp) *
Thank you for your interest in our youth exchange project. Hope to see you in Samobor in Croatia!
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