Participant Application

Personal Data

Name *
Surname *
Email Address *
Country of residence * If your Nationality is different please note.
Residence address *
Mobile phone no. *
Home telephone no.
Emergency Phone no. State phone number in case we cannot reach You.
Gender * Male/Female
Age *

Organisation data

Organisation Organisation naem, local and English
Role in Organisation member, activist, volunteer, position
Organisation telephone no. Organisation ph.no.
Email address organisation email
Org. Website Organisation website
Organisation desc. Give us a short description of your organisation (aims, activities, members)
Not a member In case you're not affiliated with an organisation but define yourself as a member of a social movement or political group, please explain and motivate :

Event

Motivation * Please explain your motivation to take active part in preparation of this event
Experience * Please list and explain previous experience (if any) with the topics of this event
Contribution * Please explain how do you think that you can contribute to the event with specific skills, topical knowledge, contacts, etc
Follow up & Multiplier effect * Please explain and motivate the channels, means and places that you're willing to use the experience and knowledge you will gather during this event.
Dietary/accesibility * Do you have any dietary and/or accessibility requirements?
Languages * Your working languages:

By clicking the Submit button, I herewith confirm that the information given in this application are correct and that I will be available for all the planned event activities during the dates mentioned in the Call for Participants.

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