Application Form Melange
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Transcript of Application Form Melange
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Melange is Viennas Programme of EVS it is co-ordinated and implemented byGrenzenlos in close co-operation with wienXtra. The programme is funded by the Cityof Vienna and the European Commission.
Grenzenlos is the coordinating organization and responsible for all technical, logisticaland administrative matters around the project but not hosting itself.
Please fill in the following details as your application, which we will forwardto our projects that will do the selection
We will inform you as soon as we received the decision.
Application forproject:
Sending organisation details
(Please be aware that we can only apply for the project together withyour sending organisation)
Name: EI-Number:
Address:
Phone: Fax:
E-mail:
Contactperson:
Curriculum Vitae
Contact Information
Surname:(Photo)
First name(s):
Address:
Postcode &city:
Country:Phone:
Email:
Personal information
Gender: Nationality:
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Date of birth: Place of birth:
PassportNumber
Person to contact in case of emergency (Name, Address, Telephone andE-mail)
Education
Your current occupation
Please describe your previous work and/or volunteer experiences (locallyand international)?
Do you have any former international experiences (other stays abroad,
exchanges etc.)?Please describe
What are your hobbies?
How would you describe your personality?
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Knowledge and skills you can share during your EVS experience:
Knowledge and skills you hope to gain during your EVS experience
Which challenges do you think you will encounter during your stay abroad?
Do you have any special needs Yes___ No___(medical conditions, handicaps etc.)?
Do you have any kind of allergy? Yes___ No___
Do you need to take any kind of medicine? Yes___ No___
Are you a vegetarian? Yes___ No___
Is there any food you do not eat? Yes___ No___
Please give further description if you have answered yes to any of theabove questions
Language abilities
Language (mark by x) Native Fluent Good Basic
German
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English
(Others)
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Your motivation Which project are you interested in?
In case you are interested in more than one project coordinated by Grenzenlos, please
send one application for each project.
EI number:
Name of the project:
When can you start theproject and for how long:
Please describe below carefully your motivation for this specific project
Is there anything else you would like to tell?
Thank you for filling in the application form! The next page is for yoursending organisation.
Please send this form addressed with the EI Number of the project you havechosen in the form (For instance 2007-AT-700) to [email protected]
Declaration
I declare that all of the information on this applicationform is honest and truthful to ability, experience andsupport needs and has been completed by the
volunteer named on this application please tick here to show
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TO BE COMPLETED BY THE SENDING ORGANIZATION
How did you select the volunteer? (Is the volunteer a member of your organisation,are you going to involve the volunteer in your current activities, did you interview thevolunteer by phone or face-to-face...)
How do you keep the volunteer motivated, how do you provide the volunteer withemotional preparation? (Cultural shock, conflict resolution, expectations, contact withex-volunteers,)
Do you provide the volunteer with theoretical preparation? (Insurance, rights and
responsibilities of the volunteer, SO and HO tasks, duties of the tutor of the project...).
Do you provide the volunteer with other kind of formation? (Languages, culturalformation about your own country and the hosting country).
In case we select your volunteer, can your organization apply for the project in your NA?
