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Please return the filled in application form by email to
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APPLICATION FORM
In the following you apply for the introductory seminar taking place in Latvia from July 16 to 26, 2012. Only short listed candidates will be informed until June 10, 2012.
The introductory seminar is the first step to be admitted as fellow and to receive a project core-funding, a specific capacity building and a mentorship.
In case you are interested to implement a voluntary project you are ask by the end of the introductory seminar to submit a project proposal which will be assessed in a jury. The project must be realized till the end of November. After this you will be invited to the reflection seminar to St-Petersburg to analyze your project experience and to present results in the general public.
Please notice that only citizen of the Russian Federation are eligible to apply who live in the North-West Russia and Kaliningrad. The project idea has to be closely connected with a challenge or problem you identify in your social environment.
| Personal information | |||||
| Family name | |||||
| Given name(s) | |||||
| Date of birth (dd/mm/yyyy) | |||||
| Place of birth | |||||
| Gender(male/female) | |||||
| Nationality | |||||
| Occupational status (school student/apprentice/college or university student/employed/ unemployed/trainee) | |||||
| Current address (street, house number, apartment) | |||||
| Postcode and city | |||||
| Region | |||||
| Telephone(with country and city code) | |||||
| Cell phone(with country and city code) | |||||
| 1st native language | |||||
| 2nd native language | |||||
| 1st foreign language (fluent/advanced/basic) | Listening | Speaking | Reading | Writing | |
| 2nd foreign language (fluent/advanced/basic) | Listening | Speaking | Reading | Writing | |
| 3rd foreign language (fluent/advanced/basic) | Listening | Speaking | Reading | Writing | |
| Educational background | ||
| College, university | Faculty, degree course, subject of study | Diploma received or expected to be received in dd/mm/yyyy) |
| Additional qualification(e.g. trainings, workshops) | ||
| Organization | Training program/subject | Duration |
| Practical experience(internships, jobs, employments, etc.) | ||
| Organization | Responsibilities | Duration |
| Civic involvement (membership in non-profit organizations, voluntary services, project participation etc.) | ||
| Organization | Activities | Duration |
| What exactly do you want to improve or to change in your personal social environment? |
| What associations and thoughts come on your mind when you hear “Power of ImagiNation? ” Why is this theme actual for your society? |
| What is your motivation for taking part in the introductory seminar? |
| What are your expectations of participating in the program? |
| Other comments: |
| How did you get to know about Bridge it!? (website, e-mailing, public announcement, mouth-to-mouth etc.) |
Please return the filled in application form by email to
bridge_it@hotmail.com
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