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Connect. Empower. Act

For a fair and sustainable world

Participant Application Form

** Deadline for submission: 25 June, 2013 **

Are you- a young, motivated person (between 16-25 years old), who wants to contribute to change in

his or her surroundings and take a stand for a better world?- concerned about local to global social and environmental problems?-

looking for opportunities to effectively implement your own project ideas?- interested in traveling and exploring fascinating natural places in Romania?- open to meet, exchange and have fun within an international environment, together with like-

minded Austrian young people, like you, as well as practice your English?

If you answered yes to all or almost all questions, then you are absolutely the right person for thisproject! Join us for this innovative and exciting project!

Where and When?- Kick Off Meeting: The opening event is an international meeting between 15 Austrian and 15

Romanian young people. It will take place in Bile Tu nad between September 1-9, 2013- 3 customized training sessions in Romania: Between September 2013 and June 2014 the

Romanian participants will meet during three weekends for 3 additional training sessions,

customized to your needs.

- Costs: This project is funded by the EU-project Youth in Action. Therefore only 30% of yourtravel costs have be covered by you. All other costs (housing, meals, outdoor activities, etc.)will be covered by the project organizers.

Part 1: Your Contact Information

Your Name: _________________________________________________First name Last name

Date of Birth: / /___Address: ___________________________________

Town/City: ___________________________________Postal code: __________________Email: _____________________________________Phone: _____________________________

Gender: Male __ / Female __

Emergency Contact Information

Parent/Legal Guardian Name:_____________________________________Phone: _______________________________

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Part 2: Your motivation

Please answer the following questions as honestly as you can. You do not have to be an excellentwriter to give great answersjust be yourself.

1. Why do you want to participate in the project Connect. Empower. Act? What do you expect

from the project?

2. What would you like to learn about the project topics: environment, equity, projectmanagement, political engagement, active citizenship, etc. during the project?

3. We believe everyone has something to offer! What is your talent? What do you bring to theproject?

4. We expect from every participant (alone or in groups) to prepare and conduct at least onepeer-to-peer workshop/training session. What topics could you teach others or which

activities could you share that would apply to our themes (environment, social issues, youthleadership, political engagement, active citizenship, etc.)?

5. Do you already have experience with social or environmental themes and projects? Have youalready been involved with projects at an international level? Please describe.

6. An important part of this program is the so-called action project, that you, (alone or ingroups) will plan and implement. The topic of your project should apply to aspects representedby Connect.Empower.Act (environmental or social themes, active citizenship, politicalengagement, etc.). Is there a specific topic that interests you? What kind of project could youimagine designing and implementing?

Part 3: Please attach your CV (English or Romanian language)

Declaration of consent:With my signature I confirm that, in case of admission to this project, I will attend and participateactively in all meetings and related actions associated with the project, given no unexpectedcircumstances prevent me from doing so.

________________ _____________________Name Date

Thank you for completing the form. Please send it until the 25th of June 2013 to Ctlina Murariu,

cmurariu@wwfdcp.ro

For further questions, dont hesitate to contact Ctlina Murariu, WWF, 0730 098 104

This project has been funded with support from the European Commission. Thiscommunication reflects the views only of the author, and the Commission cannotbe held responsible for any use which may be made of the information containedtherein.

mailto:cmurariu@wwfdcp.romailto:cmurariu@wwfdcp.ro