Application outxchange dinamo

Youth Krakowski Teatr Studencki

OUTXCHANGE OUTDOOR URBAN THEATER YOUTH EXCHANGE KRAKOW, POLAND 06.08.2010 – 16.08.2010

DÍNAMO + YOUTH KRAKOWSKI TEATR STUDENCKI

PARTICIPANT APPLICATION PERSONAL DATA FULL NAME : NATIONALITY: BIRTHDAY: SEX: HOME ADRESS: MOBILE PHONE: E-MAIL: EMERGENCY NUMBER/PERSON OF CONTACT: ARE YOU ALREADY A DÍNAMO ASSOCIATE? IF NOT, WOULD YOU LIKE TO BECOME?

MALE:

FEMALE:

(TO BE AN ASSOCIATE OF DÍNAMO IS

MANDATORY FOR PARTICIPATING ON THIS PROJECT)

SPECIAL NEEDS/LANGUAGE SKILLS YES: NO: VEGETARIAN: OTHER (PLEASE DESCRIBE): REQUIREMENTS: NOTHING YES (PLEASE REFER MEDICAL/PHYSICAL STORY AND SPECIAL RELEVANT: ASSISTANCE AND/OR MEDICATION NEEDS, OR OTHER):

SMOKER : FOOD: NO SPECIAL MEDICAL/PHYSICAL SPECIAL CONDITION (INCLUDING ALLERGIES, MEDICAL INTOLERANCES, DISEASES, HANDICAPS, ETC.): LEVEL OF ENGLISH:

(1) BASIC:

(2) MEDIUM:

(3) GOOD:

(4) VERY GOOD:

(5) MOTHERTONGUE:

OUTXCHANGE – OUTDOOR URBAN THEATER YOUTH EXCHANGE | KRAKOW, POLAND, 2010 | PARTICIPANT APPLICATION OTHER SPECIAL NEEDS:

PERSONAL BACKGROUND, EXPECTATIONS & MOTIVATION (OR THE 10 IMPORTANT SHORT QUESTIONS) PLEASE DESCRIBE YOUR THEATER (OUTDOOR OR NOT) PREVIOUS EXPERIENCE. (10 LINES MAX.) ARE YOUR CURRENTLY STUDYING? WHAT? AND IN WHICH YEAR? (10 LINES MAX.) WHAT DO YOU THINK THEATER IS? (10 LINES MAX.) WOULD YOU BE INTERESTED AND INVOLVED ON AN ONLINE PLATFORM ABOUT THIS PROJECT?

WHAT WOULD YOU LIKE TO FIND/DO IN IT? (10 LINES MAX.) WHY DO YOU WANT TO PARTICIPATE ON THIS PROJECT? HOW WOULD YOU CONTRIBUTE TO IT? (10 LINES MAX.) WHAT WOULD YOU LIKE TO FIND DURING THIS EXCHANGE PROCESS, ONCE IN KRAKOW? (10 LINES MAX.) WHAT WOULD YOU LIKE NOT TO FIND DURING THIS EXCHANGE PROCESS, ONCE IN KRAKOW? (10 LINES MAX.) DID YOU ALREADY HAVE BEEN INVOLVED IN ANY DINAMO’S ACTIVITY(IES)/EVENT(S)? WHAT WAS YOUR ROLE? (10 LINES MAX.) HOW WOULD YOU DESCRIBE YOURSELF? (YOU CAN USE WORDS, IMAGES, LINKS FOR MOVIES OR MUSICS, ETC.) (10 LINES MAX.) WHAT IS ON YOUR MIND RIGHT NOW? (10 LINES MAX.)

SIGNATURES DATE: PARTICIPANT SIGNATURE:

PLACE: PARTICIPANT EDUCATION RESPONSIBLE SIGNATURE: ONLY COMPLETELY FILLED APPLICATIONS WILL BE ACCEPTED!!!

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