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Participation Form
Youth Exchange "The Young Minds Solving Climate Change"
10.03.2022 - 19.03.2022
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have subscribed Youtube*
First Name (as in your PASSPORT)
Gender
*
Male
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Last Name (as in your PASSPORT)
ID Number
Birthday
Birth city
Email
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?
What time do you plan to arrive to Berlin?
When do you plan to departure 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.
Cyprus - Active Cypriot Programs and European Learning Into Acceptance, ACPELIA
Italy - ASSOCIAZIONE CULTURALE BEYOND BORDERS CORATO
Portugal - Associação Nó Górdio
North Macedonia - Citizen Association United Youth
Serbia - Ekolosko udruzenje fanova kampova - Eko fun kamp
Poland - EURO-MEDITERRANEAN ASSOCIATION OF EXCHANGES VOLUNTEERING EVENTS POLSKA
France - Réseau Solidaire et Participatif
Bulgaria - SNTS MLADEZHKI I GRAZHDANSKI INITSIATIVI V ROZOVATA DOLINA
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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