Rustavi and Phona village,

Move More Live Longer

Rustavi and Phona village,

Georgia 12/08/2014 –

19/08/2014

ORGANIZATION: League of Youth Voluntary Service

FIRST NAME:

SURNAME:

GENDER: □ Мale□ Female

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EMERGENCY CONTACT:

Name: Surname: Telephone:

SPECIAL NEEDS (OR HEALTH REMARKS):

PAST EXPERIENCES:

WHAT IS YOUR MOTIVATION TO TAKE PART IN THIS PROJECT?:

WHAT ARE YOUR EXPECTATIONS OF THE TRAINING?:

IF VISA IS NEEDED:

N° of passport:

Date of issue:

Date of expiry:

Date of birth:

Place of birth:

Nationality:

Дата добавления: 2015-08-27