Application Form "Participatory

Photography Project" Bile Tunad,

30.06- 10.07.2016
First name

Last name

Country

Gender
Male
Female

Birth date *

Primary e-mail to contact me *

Primary phone number to contact me *

Permanent Residency Address *

Organisation I am representing *
Address of the organisation I am representing *

Do you have any previous experience in how to increase visibility of projects and
promote their impact using Photography methods? Please explain. *

In what way are you involved in youth work/working with young people? *

Do you have any previous experience in how to increase visibility of projects and
promote their impact using photography methods? Please explain. *

Do you have a professional camera to take with you to the TC? Describe it. *
What do you think about visual content in reaching key target groups and
producing social change? Is it important? Please explain. Write examples from your
own experience. *

1. English Language Level

Please indicate your level of English. Choose between beginner, intermediate,

advanced. *
beginner
intermediate
advance

Explain your motivation to take part in this TC. *

Explain what skills and competences you want to develop by taking part in this TC. *

2. Contribution and follow-up.

In which way do you intend to use what you have learned at the TC, in your daily
work? How are you going to transmit what you have learned to your organization? *

Consult your organization members and give ideas of how can you disseminate the
results of the TC after the end of the activities once you get back home. *

Different tools will be used for dissemination such as webinars inside your
organisations, one workshop in each target country to communicate with and
gather inputs from local community stakeholders on the outcome of the TC. Are you
going to be involved in the dissemination process of the TC results between 13-30
July 2016? *

3. PRACTICALITIES.
Are you a person with fewer opportunities? (e.g. social obstacle, economic
obstacle, disabilities, educational difficulties, cultural differences, health problems,
geographical obstacles). If yes, which one of these situations do you face? *

4. Other
Do you have any special needs or requirements that the host organization should
know about (e.g. medical needs, allergies, dietary restrictions, etc.)? Otherwise
leave blank.

5. Comments
Write any important comments that you have here:

Please take note of the following conditions that will

apply if you are selected to take part in the seminar.
1. I commit myself to participate in the whole process, including: to prepare myself
carefully for the training course; to purchase flight tickets and insurance that cover
damage to third parties until 15 April, to do all remote preparation work the team will
ask for; to take part in the full duration of the TC; to participate in the whole
evaluation process, to disseminate the results of the TC immediately after the I get
back home (13-30 July 2016). *
Yes
No

2. I am responsible to obtain my own Travel/Health Insurance, this cost not being

covered by the project. *
Yes
No

3. I am aware that obtaining a health and a full travel insurance are my own
responsibility and at my own expenses. I understand that the information I provided
on my special needs does not remove my own personal responsibility for ensuring
my own health. *
Yes
No

4. I authorise the host organization and partners to publish, in whatever form and by
whatever medium, including the Internet, information about the training, results and
work done during the training, and pictures taken at the TC. *
Yes
No