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Participation Form
Training Course "Inclusive Leadership and Employment Opportunities"
17.07.2022 - 25.07.2022
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First Name (as in your PASSPORT)
Gender
*
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Last Name (as in your PASSPORT)
Birthday
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Email
ID Number
Birth city
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Phone (with international code +...)
Whatsapp number (with international code +...)
Emergency contact (name, relationship, phone number with country code)
When do you plan to arrive to Berlin?
When do you plan to departure from Berlin?
What time do you plan to arrive to 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
*
Italy - Associazione Minerva
Romania - Act O'Clock
Bulgaria - WalkTogether
Cyprus - Youth Dynamics
Spain - Asociación PROJUVEN
Lithuania - TAVO EURORA
Germany - Copernicus Berlin e.V.
Please add any additional comments if any
I hereby confirm that I am a resident of the country I represent
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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