Making growth sustainable:

Green entrepreneurship

Application Form

Timis County Bodo, 13th 22th September

NAME
SURNAME
GENDER
DATE OF BIRTH
NATIONALITY
ORGANIZATION YOU
REPRESENT

Dietary Requirements & Special Needs (food, disability, allergies, etc.):

(If you do not have any Requirements or special needs, please write NO)

CONTACT DETAILS:

MOBILE PHONE
E-MAIL ADRESS
COUNTRY
CITY
STREET
POSTAL CODE
CONTACT DETAILS ABOUT YOUR ORGANISATION:

ORGANISATION NAME
CONTACT PERSON
E-MAIL ADRESS
TELEPHONE
WEBSITE
CITY
COUNTRY
STREET
POSTAL CODE

What is your motivation to participate in this Youth Exchange?

Do you have any experience regarding the topic of the Youth Exchange?

Did you take part in such projects/activities before?

I am aware that obtaining a health and a full travel insurance are my own responsibility and at my
own expenses. I understand that the information provided on my special needs does not remove my
own personal responsibility for ensuring my own health.

I authorise the teamers to publish, in whatever form and by whatever medium, including the
Internet, the outcomes of the Youth Exchange and the pictures taken during this activity.