REGISTRATION QUESTIONNAIRE

European Solidarity Corps/collective volunteering

Strasbourg, France

The selection of participants will be carried out by the educational team in partnership with
partner organizations and we will inform you of the selection of participants.
The selection process will be based on certain criteria. Participants must be:
- be at least 18 years old and maximum 30 years old
- have artistic and entertainment skills (dance, music, percussion, singing, drawing,
calligraphy, recycling workshops, quizzes, etc.)
- be involved at the local level in youth projects
- be motivated and involved in all EVS sessions, including preparation, evaluation and
dissemination of results
- participate in the entire project
- be well prepared and willing to share learning and best practices related to the theme of the
project
- Undertakes to return to my country of origin at the end of my volunteer mission
- Undertakes to volunteer for a requested period, if the volunteer exceeds this given period
(too many days or not enough, for example a 32-day volunteering, only 26 days are
completed) the plane ticket will not be refunded.

IMPORTANT: all participants must be on time for all sessions, respecting the whole EVS
program. Furthermore, we insist that this project is NOT a tourism or vacation stay and the
participants must be motivated and interested in the content and the theme.

I – Information about the volunteer

Surname : First name :

Country : Date of birth :

Gender: Nationality :

Organization name (if applicable): Pi Private phone number (home):

Gençlik Derneği

Organization address : Akdeniz Mah. 1353 Mobile number :

Sokak No:1 Taner İş Hanı Kat:5 D:503
Konak 35210 İzmir Türkiye

Organization email and website: Address personal :

https://www.pigenclikdernegi.org/tr/ana-
sayfa/

Organization phone : +90 232 483 03 14 Personal email:

Special diet (vegetarian, Halal, gluten intolerance, food allergy, etc.):

 Please give the Surname and First name, Telephone numbers (with country code) and e-
mail of the person to contact in case of emergency.:
Full name:
Relationship:
Cell number:
Phone number (office or home):
E-mail:

II – Passport information

Passport number:
Date of issue:
Issuing authority:
Expiration date:

III – Health information

 Health conditions (medical conditions, allergies, treatments...):

Are you vaccinated against Covid-19?

Do you have comorbidities exposing you to more serious forms of Covid-19?

IV – Information on the objectives

Please briefly describe the aims/objectives and activities of your structure, as well as
your role in the organization (5 lines)

Please briefly describe

the aims/objectives and
activities of your
structure, as well as your
role in the organization
(5 lines)
How will your
organization benefit
from your participation
in this volunteering? (5
lines)
 Why exactly and
concretely do you want
to do this ESC? Your
motivations? (5 lines)

How will you concretely

contribute during the
volunteering? Please
describe how you
concretely envisage your
preparation?
What is your personal
and/or professional
experience in terms of
working and/or activities
with children and young
people?
Are you used to working
with these audiences?

Do you have traditional

instruments, costumes
(etc.) from your country
to bring and use during
activities with children?

V – Information on skills

What type of art do you practice?

 Painting  Video/Movie  Artistic performance

 Instrument/Music Theater  Improvisational theater
 Carving  Dance  Mime
 Street art  Singing  Clowns
Specify:  Other

Are you
 Amateur?  In training?  Professional?

Are you able to work in a team?

Specify:  No  I do not know

 Yes
What is your ability to communicate in an international and intercultural
environment?

Major communication problems 

none
1 2 3 4 5 6

Please briefly describe your ability to communicate in an international context:

Native language:
Language level

Other Alright Good Average

LANGUAGES

Please note the following conditions which will apply, should you be selected to
participate in this project:

1. I agree to participate in the entire process, including:

· To prepare myself well for volunteering and to do all the preparatory steps that the teaching
team will ask for.
· To participate in the whole project.
· That the organizers can share my photos and videos taken during the project for the
dissemination of the results of the project.
· To participate in the entire evaluation process.
2. I understand that information provided about my special dietary requirements and health
status does not remove my personal responsibility for ensuring my own health.

3. I have read and understood this entire document and completed the required information.

Signed by,

Surname, first name: Date and Place: