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    Application Form Be The Change! 2011

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    Marcos Ierides
    This document is a registration form for learners applying to attend a Grundtvig workshop hosted by NEAG Alternatives to Violence from December 8-14, 2011. It requests contact information from applicants, as well as information about their motivation, experience, expectations, and agreement to the terms of participating. These include attending the full workshop, completing an evaluation, and reimbursing costs if they do not attend without evidence of extenuating circumstances. The form is to be signed by both the applicant and workshop organizer upon acceptance of the candidate.

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    Download as DOC, PDF, TXT or read online from Scribd

    Application Form Be The Change! 2011

    Uploaded by

    Marcos Ierides
    19 views5 pages
    This document is a registration form for learners applying to attend a Grundtvig workshop hosted by NEAG Alternatives to Violence from December 8-14, 2011. It requests contact information from applicants, as well as information about their motivation, experience, expectations, and agreement to the terms of participating. These include attending the full workshop, completing an evaluation, and reimbursing costs if they do not attend without evidence of extenuating circumstances. The form is to be signed by both the applicant and workshop organizer upon acceptance of the candidate.

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    Application Form Be the Change! 2011

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    This document is a registration form for learners applying to attend a Grundtvig workshop hosted by NEAG Alternatives to Violence from December 8-14, 2011. It requests contact information from applicants, as well as information about their motivation, experience, expectations, and agreement to the terms of participating. These include attending the full workshop, completing an evaluation, and reimbursing costs if they do not attend without evidence of extenuating circumstances. The form is to be signed by both the applicant and workshop organizer upon acceptance of the candidate.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    19 views5 pages

    Application Form Be The Change! 2011

    Uploaded by

    Marcos Ierides
    This document is a registration form for learners applying to attend a Grundtvig workshop hosted by NEAG Alternatives to Violence from December 8-14, 2011. It requests contact information from applicants, as well as information about their motivation, experience, expectations, and agreement to the terms of participating. These include attending the full workshop, completing an evaluation, and reimbursing costs if they do not attend without evidence of extenuating circumstances. The form is to be signed by both the applicant and workshop organizer upon acceptance of the candidate.

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    GRUNDTVIG WORKSHOPS Registration form and agreement WS-learner 04/03/10

    LIFELONG LEARNING PROGRAMME GRUNDTVIG WORKSHOPS Learner application form

    Please send this application form duly completed and signed to: - the institution which organises the Workshop (Workshop organiser) - the Grundtvig National Agency in your country Addresses of National Agencies are available on the following web page: http://ec.europa.eu/education/programmes/llp/national_en.html

    Deadline for sending the registration form1: 1 October 2010


    If your candidature to this Workshop is accepted, the Workshop organiser will return to you a signed copy of this form.

    I - Identification of the Workshop


    Title of the Workshop Host institution Dates of the Workshop Be the Change! NEAG Alternatives to Violence Arrival day and start programme 08-12-2011 Closing session and departure day 14-12-2011

    To be pre-filled by the Workshop organiser 1

    GRUNDTVIG WORKSHOPS Registration form and agreement WS-learner 04/03/10

    II - Identification of the candidate learner


    II.1. Contact details
    Title (M/Ms/Mrs) Family name Address Postcode Country Telephone 1 Mobile E-mail address Telephone 2 Fax City First name

    II.1. Other information Date of birth Nationality Occupation (if applicable). If retired / unemployed: what former job did you do? Special requirements for travels and/or during the stay (mobility, dietary, medical, etc) Experience with former international activities Motivation to participate in this workshop (Max. 150 words)

    Languages spoken Languages understood Other information you would like to mention

    GRUNDTVIG WORKSHOPS Registration form and agreement WS-learner 04/03/10

    II.3 Other questions

    PLEASE INCLUDE YOUR CV!


    How did you receive the information on this workshop? * the EU workshop catalogue: yes/no * through a person or organisation in the NEAG/Diversity Joy network : name , address . * other: .. Why do you consider yourself as being part of the target group? If not why do you want to register? Main field of action of the organisation or structure in which you work as a volunteer or semi professional (indicate name, address and website) Do you have any experience in working with groups? In which field? (indicate average age of participants) Are you a student and/or young professional starting to learn about building cohesion in groups? Which possibilities are available to you to implement HIPP workshops in your (work)environment? What are your expectations regarding the programme? Do you agree that the maximum grant for all travel costs is 250? Do you agree to be accommodated in 2-10 person sleeping rooms 3

    GRUNDTVIG WORKSHOPS Registration form and agreement WS-learner 04/03/10

    and you have to bring your own towels? If you wish to apply for preparatory costs, please state the reason why and specify the costs.

    PLEASE INCLUDE YOUR CV!

    GRUNDTVIG WORKSHOPS Registration form and agreement WS-learner 04/03/10

    CANDIDATE LEARNER I confirm that I understand and intend to obey to the following principles and rules: 1. The Workshop organiser will select candidates according to selection rules which have been approved by its Lifelong Learning / Grundtvig National Agencies. These include rules on the minimum number of learners from a varied number of countries; 2. Candidates may be selected, rejected or registered on a reserve list; 3. The Workshop organiser may consult the selected learners to organise their trips and accommodation; 4. By signing the present document, the candidate learner commits himself / herself to: a) participate in only one Workshop throughout the EU within 3 years b) if case of selection: i. attend the Workshop ii. comply with all arrangements negotiated for his/her participation and to do his/her best to make the Workshop a success iii. fill in and sign a final evaluation form at the end of the Workshop and send a copy of it to the National Agency of his/her country. c) in case of selection but non attendance: present evidence of force majeure, d) in case of non attendance and no presentation of evidence of force majeure, reimburse the Workshop organiser of all costs incurred due to this non-attendance.

    Date:

    Signature:

    WORKSHOP ORGANISER We confirm that the above mentioned candidate has been accepted to attend the following Workshop and will do our best to provide him/her with a successful experience, as described in our application form. TITLE: .. DATES: LOCATION: ..

    Date:
    1

    Signature1:

    And stamp of the organisation 5

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