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APPLICATION FORM

Youth in Action 3.1 Training Course Theatre for Roma Inclusion - TRI 21 – 28 April, 2014, Belgrade, Ser ia

PERSONAL DATA
Name Surname Date of birth Se ! !"# Occu"ation A##ress Cit$ Countr$ Email Tele"hone %ebsite En&lish lan&ua&e! $luent"good" asic Do $ou ha'e an$ s"ecific nee#s or re(uirements that the host or&anisation shoul# )no* about+
With the support of the Youth in Action Programme of the European Union.

,- .o* #i# $ou fin# out about this "ro/ect+ 0- Please #escribe $our fiel# of *or) or stu#$+ 1- Please #escribe shortl$ $our in'ol'ement in local or international "ro/ects as trainer $outh2 *or)er2other- Are $ou member of an$ or&ani3ation+ Please #escribe it shortl$4- %hat #oes #iscrimination means to $ou+ 5- %hat #oes inclusion means to $ou+ 6- Do $ou ha'e an$ e "erience in *or)in& *ith Roma "eo"le+ Please #escribe shortl$7- Do $ou ha'e e "erience *ith "ro/ects of the Euro"ean "ro&ram 8outh in Action2Erasmus9+ :- Are $ou familiar *ith theatre metho#olo&$ as social chan&e tool+ %hat is $our e "erience; if an$+ <- %hat is $our moti'ation to be "art of this "ro/ect+ ,=- %hat *oul# $ou li)e to &ain b$ ta)in& "art in this trainin& course+ An# *hat to &i'e+ ,,- If $ou *ere a mo'ie; *hat )in# of &enre *oul# $ou be+

Declaration! % agree that &' personal data gi(en in this application &a' e &ade a(aila le to other participants. % underta)e to participate $or the *hole duration o$ the training course. %t is &' personal responsi ilit' $or ensuring &' o*n health. Date! Name an# surname of "artici"ant!

A""lication!
+lease do $ind attached application $or&, $ill it and send it to ,elena.,e-do(ic.g&ail.co& . A""lication #ea#line is ,=th March 0=,4- Announcement of the results *ill be until ,5th March 0=,4FOR AN8 ADDITIONAL INFORMATION PLEASE DO CONTACT! /elena /e-do(ic, 01AC2 +ro,ect coordinator ,elena.,e-do(ic.g&ail.co&
With the support of the Youth in Action Programme of the European Union.

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With the support of the Youth in Action Programme of the European Union.