Application Form – Act Global Training Course
[db_form id=Bali_Training_Course]for Training Course “Euro-Asi”, March to December 2015 in Denpasar, Bali.
Your details
The contact details you provide us below will be used for all correspondence!
[label]Full name (as on your passport)[/label] [input name=sql_full_name required=true] [label]Place of Birth[/label] [input name=sql_place of birth required=true] [label]Date of birth (DD/MM/YYYY)[/label] [input name=sql_dob required=true] [label]Gender[/label] [select name=sql_gender required=true options=Please_choose;Male;Female] [label]Address[/label] [input name=sql_home_address required=true] [label]Post code[/label] [input name=sql_home_postcode required=true] [label]City[/label] [input name=sql_city required=true] [label]Country[/label] [input name=sql_country required=true] [label]Phone(preferably mobile with full international dial codes)[/label] [input name=sql_phone required=true] [label]E-mail[/label] [input name=sql_email required=true]
Language(s) spoken:
Please mention all languages in which you are able to work and indicate your level for each of it (B-basic, G-good, VG-very good, F-fluent, MT-mother tongue)
Please note that working language for this course will be English.
[textarea name=sql_language_abilities required=true close=false]Do you have any special needs or requirements that the host organization should know about?
(E.g. mobility, medical needs, allergies, dietary restrictions, smoker/non-smoker)
[textarea name=sql_special_needs required=false close=false]Your organization (if applicable)
[label]Name of your organization[/label][input name=sql_organization_name required=false] [label]Complete address[/label][input name=sql_organization_address required=false] [label]Phone [with full international dial codes][/label][input name=sql_organization_phone required=false] [label]Website[/label][input name=sql_organization_website required=false] [label]Email[/label][input name=sql_organization_email required=false]Please describe briefly your organization
What are the objectives, main activities and target group of your organization?
[textarea name=sql_organization_description required=false close=false]What is your role (volunteer, youth worker, board member, director …) and your tasks? Please also tell us how long you have been involved in youth work?
[textarea name=sql_organization_roles required=false close=false]Knowledge and experiences
What is your personal/professional experience in relation with the topics of the training course ?
[textarea name=sql_subject-to-learn required=true close=false]What would you like to learn, understand and experience during this training course?
(approximately 4-6 sentences).
Is there any specific topic you are most interested to learn?
[textarea name=sql_specific-topic required=false close=false]Anything else we forgot to ask but you would like to add?
[textarea name=sql_misc required=false close=false] [submit value=Send_Application] [send_confirmation]Thank you for your submitted application for Act Global Training Course.
Our team will contact you shortly if you are selected to attend this training course.
[/send_confirmation] [/db_form]
