APPLICATION FORM FOR CANDIDATES

FOR PROJECT

Organised by:

Institute for Eastern Initiatives (Krakow, Poland)

Financed by:

Department of Public and Cultural Diplomacy
of the Ministry of Foreign Affairs of Republic of Poland

YOUR PERSONAL DATA:

Surname:
First name:
Date of birth: Choose date
Gender:
Place of residence:
Nationality:
E-mail:

YOUR ORGANISATION:

Name:
Address:
Telephone/Fax:
Legal representative:
Contact person:
E-mail:

Do you need a visa to come to Poland?

Yes / ☐ / No / ☐

Do you have a passport valid until 27th of January 2016 (6 months after the end of the Summer School)? Complete only if you need passport to come to Poland:

Yes / ☐ / No / ☐

What is your level of English?

Basic / Intermediate / Advanced / Fluent/Native
Reading / ☐ / ☐ / ☐ / ☐
Writing / ☐ / ☐ / ☐ / ☐
Speaking / ☐ / ☐ / ☐ / ☐
Listening / ☐ / ☐ / ☐ / ☐

For the purpose of selection of the candidates, please answer the following questions:

What is your motivation to participate in the project?

Do you have any previous experience in projects devoted to multiculturalism, intercultural dialogue or active citizenship? If yes, please describe.

Do you have any ideas for projects or initiatives that you could develop after participation in the Summer School? What type of activities?

What in your opinion is the most important thing from Polish history/culture/economy that is worth sharing abroad? How citizens from other countries could benefit from this knowledge?

Have you ever been to Poland before?

By sending this form I hereby give consent for my personal data included in the application form to be processed for the purposes of recruitment under the Data Protection Act 1997 (Dz. U. no. 133, item 133).

I wish to obtain by email information about events, programs and activities organised by Institute for Eastern Initiatives:

Yes / ☐ / No / ☐

Project ‘Get to Know about Poland’ is financed by

the Department of Public and Cultural Diplomacy

of the Ministry of Foreign Affairs of Republic of Poland