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The deadline for submitting your application is June 10, 2013.
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APPLICATION FORM
In the following you apply for the introductory seminar “Power of Imagination” of the program “Bridge it! ” taking place in Pelč i, Latvia from July 11 to 20, 2013. Short listed candidates will be informed until June 17, 2013.
The introductory seminar is the first step to be admitted as fellow of the “Bridge it! ” program and to receive a project core-funding, a specific capacity building and a mentorship.
Please notice that citizens living only in Latvia, Lithuania, Estonia and the North-West regions of the Russian Federation and Kaliningrad are eligible to apply.
Board, lodging and 50% of travel costs for the seminar will be covered or reimbursed by the organizers.
| Personal information | ||
| Family name | ||
| Given name(s) | ||
| Date of birth (dd/mm/yyyy) | ||
| Gender(male/female) | ||
| Nationality | ||
| Occupational status (school student/apprentice/college or university student/employed/ unemployed/trainee) | ||
| Current address (street, house number, apartment, city, postcode, country) | ||
| Telephone(with country and city code) | ||
| Cell phone(with country and city code) | ||
| 1st native language | ||
| 2nd native language | ||
| 1st foreign language (fluent/advanced/basic) | ||
| 2nd foreign language(fluent/advanced/basic) | ||
| 3rd foreign language (fluent/advanced/basic) | ||
| Educational background | ||
| College, university | Faculty, degree course, subject of study | Duration |
| Additional qualification(e.g. trainings, workshops) | ||
| Organization | Training program/subject | Duration |
| Practical experience(internships, jobs, employments, etc.) | ||
| Organization | Responsibilities | Duration |
| Civic involvement (membership in non-profit organizations, voluntary services, project participation etc.) | ||
| Organization | Activities | Duration |
| What exactly do you want to improve or to change in your personal social environment? |
| What associations and thoughts come on your mind when you hear “Power of ImagiNation? ” Why is this theme actual for your society? |
| Other comments: |
| How did you get to know about Bridge it!? (website, e-mailing, public announcement, mouth-to-mouth etc.) |
Please return the filled in application form by e-mail to
leimane@bridgeit.eu
The deadline for submitting your application is June 10, 2013.
