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Application Form:Paving the Future Youth Forum

Application form

Family name, given name

Date of birth

Nationality

Gender

Home address (incl. country)

Contact telephone number (incl. international code)

Contact e-mail address

Have you taken part in any previous British Council projects? If so, which ones?

Educational background

Have you ever travelled or worked outside your country? If so, which countries have you visited?

The United Kingdoms international organisation for educational opportunities and cultural relations. We are registered in England as a charity.

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What communities and networks are you active in?

Volunteer work, community work & activism

What areas does your community work/activism cover?

_ Children and Youth_ Civic Participation_ Communication_ Culture_ Education_ Entrepreneurism_ Environment_ Food_ Health and Disabilities

_ Homelessness_ Human Rights_ Labour Conditions and Unemployment_ Technology_ Transportation_ Waste Management & Recycling_ Water_ Women's Rights_ Other: ___________________________

Other work experience

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Tell us in 4-5 sentences about your activism or community work. What do you do? What is mostnoteworthy about this work? What is most gratifying or most difficult?

We may be using quotes from your application form for publicity purposes. We may also use theinformation you provide for the purpose of administering the Global Changemakers project and toobtain data on the audience we are reaching, and we may share some of the information with the

WEF. If you DO NOT want your application to be used for these purposes please tick the box.

I DO NOT want any material from my application to be used except in theselection process.

We may contact you to inform you of other British Council activities, events and services that maybe of interest to you. If you DO NOT wish to be contacted for this purpose please tick the box.Please remember that if you tick the box we will be unable to provide you with information aboutfuture events and promotional activities.

I DO NOT wish to be contacted.

Date: Signature: ________________________________________

Data Protection 1998 NoticeThe British Council will use the information you have given on this form to select participants forthe Global change maker projectYour information will be shared at this stage only with individuals selecting candidates for theforum.By submitting this form you consent to our processing sensitive personal data about you where thisis necessary, for the purpose above. You also agree that that we may share your informationamong our offices around the world where this is necessary for the above purpose. Your records

will continue to be handled in accordance with our data protection policy. You have the right to askfor a copy of the information we hold on you, for which we will charge a fee. Contact the DataProtection Officer by e-mail at: dataprotection@britishcouncil.org or send in your request to:Data Protection OfficerBritish Council10 Spring GardensLondonUnited KingdomSW1A 2BN

If you feel that the information we hold about you is inaccurate please contact the British Council.

Please return the completed form to: mohammed.shawish@britishcouncil.org