Your working languages (please mention all languages in which you
are able to work)
English •
French •
German •
Spanish •
Russian
Other languages (please specify):
Main profession or occupation:
COMPLETE HOME ADDRESS: (Please note that all the correspondence
will be sent to this address, so please ensure it is complete.)
Street and number:
Postal Code:
City/Town:
Country:
Tel Home:
Tel Work:
Tel Mobile:
Tel Fax:
E-mail:
II. INFORMATION ON THE ORGANISATION/INSTITUTION
Sending organisation:
Street and number:
Postal Code:
City/Town:
Country:
Tel Home:
Tel Work:
Tel Mobile:
Tel Fax:
E-mail:
Contact person:
Web address:
Your organisation/institution is…
an international youth
organisation
a national youth council
a national youth organisation
a local/regional youth
organisation
a local, regional or
national authority
a
non-governmental organisation (not youth one)
other (please specify):
Please describe briefly the scope and the main activities of the
organization/ institution:
What is your role / position within your organisation?
other, please specify
III. EXPERIENCE IN YOUTH WORK
What experience do you have in international / regional youth work
/ activities?
What type of training (if any) have you followed regarding
international / regional youth work?
IV. MOTIVATIONS AND EXPECTATIONS
What is your motivation for taking part in this study session?
What is your organisations’ interest in sending you to this study
session?
What do you expect from this study session?
How can you contribute to the study session?
What are your most important needs?
How do you plan to make use of what you shall learn in the study
session?
Please give your comment on: ‘Regional cohesion for me is …..
V. PRACTICAL ISSUES
Do you have any special needs or requirements (e.g. dietary,
disability, etc.)?
If you are accepted as a participant on this study session, will
you require assistance in obtaining a visa for Hungary?
No Yes • if yes,
please indicate:
Date of birth
Passport No.:
Issued at (place):
Date of issue:
Date of expiry:
How much (approximately) will be your
travel and visa costs?
Date:
Signature (Type your full name):
Please, send back the application form till 31 December 2002 to:
Intercultural Institute
str. Miron Costin, nr. 2
Timisoara 1900
Romania
