th October 2014 - 6th August 2015

This application form is your first step into applying for this EVS project. In section 2 where it says “motivation letter” you should let us know who you are, what defines you and why we should choose you! Write everything that you find relevant about yourself and your interest for the project, but please be honest and direct!

After you’ve completed this application form, this is what you should do:

1- Save it as a Word file with your name and name of the project (for example: Maria Honore_creative youth).

2- Go to this google form: https://docs.google.com/forms/d/1c_ErI2eZQagHgN0JtFbEOoszC9_cXdgmNEYfSGm4Hhw/viewform and please fill in the information (again!) that is asked.

3- Wait for an e-mail around the 25^th of April saying whether you have been selected or not.

Good luck!!!

	Your Picture

Full Name
Date of Birth/ Age	Dd/mm/yyyy AGE:?	Place of Birth: (Town, Country)
Nationality		Passport/ Identity card number (EU Citizens)

Email		Mobile phone	00….
Emergency contact (Name, Mail, Phone Number)
Are you currently	Ј Studying Ј Working Ј Unemployed (not studying or working)   Ј Other ________________________________

2. MOTIVATION LETTER  

1. MOTIVATION LETTER 1. MOTIVATION LETTER

3.1-Linguistic competences
Languages	Basics	Some	Good	Fluent
?
??
??
???

3.2- Education Diplomas (professional training, first degree, master, etc… Please write the educational areas, the place and years)

3.3– Work / Work Oriented Experience(please write the tasks, duration and placement. If you haven’t worked before just write “NO”)

3.4- Other Courses / Experiences (trainings, camps, volunteering, youth exchanges, Erasmus, Leonardo da Vinci… please write the place and time)

4.1- Any Other Useful Information(diseases, allergies, dietary needs, anything that might influence your project and is important for us to know)

4.2 - Do you have less opportunities to participate in transnational projects than other people(such as voluntary work periods abroad)?

Yes No

4.2.1 - If yes, please tick the boxes, which describe your situation:

cultural differences economic difficulties (e.g. refugee or minority background) (e.g. unemployment or low income) disability or health problems educational difficulties (e.g. chronic health problem) (e.g. learning difficulties or early school-leaving) geographical obstacles social challenges (e.g. rural or remote location) (e.g. having faced discrimination) Further information on your situation: __________________________________________________________________________________  

Name	Youth NGO Iskra
PIC NUMBER		Accreditation number	2011-PL-145
Full Address	Chkalova St. 63, 54055 Mykolaiv, Ukraine
Contact Person in charge of EVS	Name:Ms. Iryna LYSENKO E-mail:[e-mail] Phone:[phone]
Your relationship with your SO   (Ex-volunteer, worked there, participated in activities, none at all…)	volunteer

Thank you. You will soon hear from us.

Дата добавления: 2015-10-24