Application Form_Get Employed
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Hrvatska škola Outward Bound™ Outward Bound™ Croatia 1. COURSE PARTICULARS Name Youth exchange „Get Employed“ Date and place 2 -10.11.2015. Samobor, Croatia 2. PARTICIPANT'S PARTICULARS First, last name Date of birth, Age Se x Passport number Address City, postal code Country Phone number E-mail Facebook name (to add you in Facebook group of the project) Occupation T-shirt size (XS, S, M, L, XL, XXL) 3. CONTACT PERSON'S PARTICULARS (In case of emergency) First, last name Address Phone number Relation to participant 1/5
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Aplikacija za poziv za učesnike iz BiH na razmjeni mladih "Get employed"02.11. - 10.11. Samobor, Hrvatska.ROK za prijavu: 27.10.2015. do 12:00Prijave slati na: [email protected] main goal of the project is to enrich theparticipants with a highly valuable experience fortheir future steps in getting a job through differentnon-formal methods of learning and interactiveworkshops, practical real life examples, role plays,simulations, personal action plan, every dayreflections and intercultural learning.
Transcript of Application Form_Get Employed
Hrvatska škola Outward Bound™Outward Bound™ Croatia
1. COURSE PARTICULARS
Name Youth exchange „Get Employed“
Date and place 2 -10.11.2015. Samobor, Croatia
2. PARTICIPANT'S PARTICULARS
First, last name
Date of birth, Age SexPassport numberAddressCity, postal codeCountryPhone numberE-mailFacebook name (to add you in Facebook group of the project)OccupationT-shirt size (XS, S, M, L, XL, XXL)
3. CONTACT PERSON'S PARTICULARS(In case of emergency)
First, last nameAddressPhone numberRelation to participant
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Hrvatska škola Outward Bound™Outward Bound™ Croatia
4. MOTIVATION FOR THE EXCHANGE
Please answer each question, give true answers, specific to you. Consider, that based on your answers we can develop the program in a way that serves your needs.
General answers do not support.
What makes you interested in this exchange?(min. 50 words)
What personal skills do you want to practice and develop? (min. 50 words)
What results do you expect concerning your personal development? (min. 50 words)
What do you want to learn concerning the themes of the exchange? (min. 20 – 50 words)
In which areas of your life do you want to use what you learn here? (min. 50 words)
Questions, remarks, anything else you want to add:
Special diets and needs (vegetarian, religious diets, physical limitations): _________________________________________________________
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Hrvatska škola Outward Bound™Outward Bound™ Croatia
5. PARTICIPANT'S MEDICAL PROFILE
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Hrvatska škola Outward Bound™Outward Bound™ Croatia
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Do you have any of the following conditions?
Please answer YES Or NO.If Yes please explain:
Yes No Explanation
-Heart problems
-High blood pressure
-Asthma
-Other respiratory/lung problems?
-Difficulty breathing when excercising
-Chronic Cough
-Headaches
-Epilepsy
-Fainting
Do you have any of the following conditions?
Please answer YES Or NO.If YES please explain:
Yes No Explanation
-Diabetes
ALLERGIES to medicines/food/insects/?
If YES,-Please describe your reaction.-Have you had Anaphylaxis?-Have you been hospitalized?
Have you been Hospitalized within the last 2 years?
Do you have bone or joint problems?
Do you have any skin diseases or sensitivities?
Please list any Medications and dosages if you use them
Have you recieved tuberculosis and/or typhoid fever vaccinations?Have you received immunizations and Tetanus shot?
Hrvatska škola Outward Bound™Outward Bound™ Croatia
……………………… …………………………… …..…………………Participant’s name Signature Date
FILLEd APPLICATION TO BE SENT TO: [email protected]
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