Name and Surname
*
Email
*
Phone number
*
Gender
*
Male
Female
Other
Birth Date
-
Ay
-
Gün
Yıl
2 digit month, 2 digit day, 4 digit year
Tarih
Current occupation status (student, employed, unemployed,...)
*
Which city are you live in ?
*
Emergency contact - number, name, relationship (mother, father, brother)
*
Have you ever participated in some other youth exchange or educational event abroad?
*
YES
NO
If yes, on how many?
What is your motivation to participate in the project? (Max 100 words)
Do you think you belong to youth with fewer opportunities - higher chance of selection (e.g. member of minority, LGBT community, from rural area, from disadvantaged background, person that face stereotypes?)
Do you have some special needs or requests? (e.g. vegetarian food, lactose free, no pork, allergy, medical conditions etc?) If not leave empty
Vaccination status? (Participants will not be chosen by this matter, this information just help us to follow the procedures with traveling)
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Vaccinated (2 doses) or Johnson (1 dose)
Unvaccinated
Recently recovered (won´t pass more than 6 months in February since your positive test)
Vaccinated (3 doses)
I am not vaccinated but I will be fully vaccinated before the project
Other
Do you have green passaport?
YES
NO
I hereby confirm, that I give permission to organizations AIAYA to process provided personal data in this form for the purposes of the selection of participants.
*
I confirm
Submit
Should be Empty: