PART 1: GENERAL INFORMATION
Date: 2015-10-07; view: 474.
Training Course
3rd - 10th September 2013 | Azerbaijan/Baku
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| First Name(s): | Surname: | |||||
| Date of Birth: | Gender: | |||||
| Nationality: | ||||||
| Home address: | ||||||
| Phone number: [with full international dial codes] | ||||||
| Email Address: | Skype: | |||||
| Passport Number: [Passport you will use for travel] | Expiry date of Passport: | |||||
| Place of issue of Passport: | ||||||
| Do you have any special needs / requirements (diet, health problems, allergies, mobility problems etc.)? | ||||||
| If yes, please give details. | ||||||
| Name of the organisation you are representing: | ||||||
| Your function/ position in the organisation: | ||||||
| Address of organisation: | ||||||
| Phone of org.: [with full international dial codes] | Fax of org: | |||||
| Website of org: | Email of org: | |||||
| Please indicate the name and full contact details of a person to be contacted in case of emergency: | ||||||
| Full Name of Contact Person: | Relationship to you: | |||||
| Full Address of Contact Person: | ||||||
| Contact Person's Phone: [with full international dial codes] | ||||||
| Email: | Skype: | |||||
PART 2: PREVIOUS EXPERIENCE OF YOUTH WORK
| Tell us about your organisation. What is its target group and main activities? |
| Tell us about yourself - including your role in the organisation and your experience with youth work |
| Have you ever participated in a Youth Exchange or Training course under the Youth in Action programme? |
| If yes, please tell us more about it. |
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| Universal | | | Applied Mathematics |