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Erasmus+: Youth, Key Action 1: Youth Exchange
Venue: Casal d' Esplai El Saler, Valencia, Spain
Youth Exchange dates: 2—9 October 2022

APPLICANT INFORMATION

Name *

Surname *

Gender *

Date of birth *

YYYY

Age at the time of the project: *

Citizenship *

Full address *

Current country of residence *

Region: *

Email address *

Mobile phone number *

Link to your social media profile *

Where/how did you find out about this project? *

Passport expiry date (if you do not own a passport, please do NOT apply for this project) *

YYYY

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) *

Please let us know about your Covid-19 vaccination status: *

I will be fully vaccinated with a two-dose vaccine. At least 14 days will have passed since my 2nd vaccination and the start of this project

I will be fully vaccinated with a single-dose vaccine (Johnson&Johnson). At least 21 days will have passed since my vaccine and the start of this project

I will only have received the first vaccine (of a two-dose vaccine)

I do not intend to be vaccinated

I have recovered from Covid-19 disease (and I have a certificate proving so). It will have been fewer than 180 days since my first positive Covid-19 PCR test and the end of this project.

Other:

Please tell us if you find yourself in any of the following categories:

Please tell us if you find yourself in any of the categories listed above (please include if you are a student): *

Language abilities in English *

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

Address

Website

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?

Please describe your organization briefly. What are the objectives, main activities and target group of your organization?

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