Application Form – Bali training
[db_form id=UK_VI_Training]for Training Course Euro-Asi – From Europe to Asia: capitalising experience in Youth work, March to December 2015 in Bali, Indonesia
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 and Date of birth (DD/MM/YYYY)[/label] [input name=sql_dob required=true] [label]Gender[/label] [select name=sql_gender required=true options=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[/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 we 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[/label][input name=sql_organization_phone required=false] [label]Website address[/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 (i.e. volunteer, youth worker, board member, director) and your tasks? Please also tell us how long you have been involved in this organisation and 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_personal_motivation required=true 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]
