4.

3 Training Registration form and agreement 03/12/12

YOUTH IN ACTION PROGRAMME

4.3 Training and networking of those active in youth work and youth organisations. 2012 Application Form Registration form and agreement. 03/12/12

Please send this application form duly completed and signed to: Raphael : raphael@everythingispossible.eu

Deadline for sending the registration form1: 6th November 2012, 1pm.

If your candidature to this Training is accepted, the Training Organiser will return to you a signed copy of this form.

I - Identification of the Training1

Title of the Training Host institution Dates of the Training A Common Wealth (Promoting Intercultural Dialogue Through Sport) Everything is Possible UK 03/12/2012-07/12/2012 (including travel days)

1 1

To be pre-filled by the Training organiser 1

4.3 Training Registration form and agreement 03/12/12

II - Identification of the candidate trainee

II.1. Contact details
Title (Mr/Ms) Family name Address Postcode Country Telephone 1 Mobile E-mail address Telephone 2 Fax City First name

II.1. Other information Date of birth Nationality Occupation (if applicable). If retired / unemployed: what former job did you do? Special requirements for travels and/or during the stay (mobility, dietary, medical, etc) Experience with former international activities Motivation to participate in this training Languages spoken Languages understood Other information you would like to mention Max. 150 words

4.3 Training Registration form and agreement 03/12/12

II.3 Other questions 1*Additional support needs 2*Support Organisation Name of the organisation: Contact name: Email address: Phone: Fax: Website: 1* Please note that this training course is targeting groups of 6 people (18+, mixed group of males and females) from United Kingdom only (England, Northern Ireland, Scotland and Wales) including one tutor and 5 other participants. 2*Where there is a support organisation identified we will liaise with this organisation in addition to the individual trainees in order to offer support for pre-preparation for learners. We will also send out information and support packs to any support organisations whose trainees register for this workshop. We would welcome a Curriculum Vitae being attached to this application however this is not compulsory.

4.3 Training Registration form and agreement 03/12/12

CANDIDATE TRAINEE I confirm that I understand and intend to obey to the following principles and rules: 1. The Training Organiser will select candidates according to selection rules which have been approved by his/her Youth in Action National Agency. These include rules on the minimum number of learners from a varied number of countries; 2. Candidates may be selected, rejected or registered on a reserve list; 3. The Training Organiser may consult the selected trainees to organise their trips and accommodation; 4. By signing the present document, the candidate trainee commits himself / herself to: a) participate in only one 4.3 Training throughout the EU within 3 years b) if case of selection: i. attend the Training from the 03.12.2012 to the 07.12.2012 ii. comply with all arrangements negotiated for his/her participation and to do his/her best to make the Training a success iii. fill in and sign a final evaluation form at the end of the Workshop and send a copy of it to the National Agency of his/her country1. c) in case of selection but non attendance: to present evidence of force majeure, d) in case of partial or non attendance and no presentation of evidence of force majeure, reimburse the Training Organiser of all costs incurred due to this non-attendance. 5. In signing this paper, I agree that the pictures, videos and the testimonials about me taken
during this 4.3 Training course, will be shared with Everything is Possible and used and included in promotional materials (such as websites, blogs, leaflets, booklets, press kit, posters, newsletters, annual reports, press, videos, Facebook, Twitter, Youtube, Flickr, etc.) which will be developed by Everything is Possible to promote its activities, but also the 4.3 Training and networking of those active in youth work and youth organisations action and the Youth in Action Programme. Date: Full Name: Signature:

TRAINING ORGANISER (by Everything Is Possible) We confirm that the above mentioned candidate has been accepted to attend the following Training and will do our best to provide him/her with a successful experience, as described in our application form. TITLE: .. DATES: LOCATION: .. Date: Signature2:

Coordinates of all National Agencies: http://ec.europa.eu/education/lifelong-learningprogramme/doc1208_en.htm And stamp of the organisation 4