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participation form
Youth Exchange "Social Inclusion and Migrant Participation in Society"
03/09/2022 - 03/16/2022
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have subscribed Youtube*
First Name (as in your PASSPORT)
Gender
*
Male
Female
Last Name (as in your PASSPORT)
ID Number
birthday
Birth city
E-mail
Phone (with international code +...)
Whatsapp number (with international code +...)
Emergency contact (name, relationship, phone number with country code)
When do you plan to come to Berlin?
What time do you plan to arrive to Berlin?
When do you plan to depart from Berlin?
What time do you plan to departure from Berlin?
Please specify if you have any special needs (vegetarian, vegan, health issue etc.)
Have you been vaccinated against COVID-19?
*
Yes
No
With which vaccine are you vaccinated?
Have you recovered from COVID-19?
*
Yes
No
Do you have EU Digital COVID Certificate?
*
Yes
No
How many shots of vaccine have you received?
Select your sending organisation
*
Germany - Copernicus Berlin e.V.
Spain - ASOCIACION ARRABAL AID
Poland - EURO-MEDITERRANEAN ASSOCIATION OF EXCHANGES VOLUNTEERING EVENTS POLSKA
North Macedonia - Center for Culture, Communication and Education of Roma "Svetla idnina - Bright Future" Kocani
Lithuania - Asociacija Jaunimo Europa
Turkey - Topluma Destek Dernegi
Please add any additional comments if any
I agree that during this training course pictures and/or videos of the participants will be taken and published on the homepage (https://www.copernicusberlin.de/), in (print) publications, on the Facebook, Twitter, Instagram, Youtube, LinkedIn pages of COPERNICUS BERLIN and may be saved for this purpose*
I have read and accept the terms and conditions stated in the
participant declaration*
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