EUROPEAN YOUTH SUMMIT 100 FOR THE NEXT 100 IN THE DANUBE REGION Sarajevo, Bosnia an Her!

e"ovina, #$ne %&', (01% APP)I*ATION FORM Persona+ in,or-a.ion

Surname Sex Citizenship Mailing address Postcode /City/Country Phone m f Date of birth E mail First name Place of birth Passport no.

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Dates: Position: Main activities Dates: Position: Main activities Dates: Position: Main activities Dates: Position: Main activities Dates: University:

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Faculty Module Dates: University: Faculty Module Dates: Type: Dates: Type: Languages1 Personal skills

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Please specify your le"el# beginner$ intermediate or ad"anced.

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Presentation and public appearance s%ills Public campaigning &obbying and ad"ocacy 'in the E() Pro*ect proposal +riting Fundraising Social entrepreneurship

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,ame - Surname Position .rganisation Email / Phone

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/ hereby declare that the information abo"e is true and correct. Please note that gi"ing misleading or untruthful statements is sub*ect to a processing fee of !001 of the total amount of scholarship. / agree to the storage and processing of my personal data by the Forum 2lpbach ,et+or%.

P&2CE 2,D D23E#

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7ou +ill participate in one +or%shop$ ho+e"er8 in order to accommodate all participants to +or%shops of their interest8 +e +ould %indly as% you to indicate three preferences and ran% them accordingly.
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