Application form



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Date05.01.2017
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APPLICATION FORM
for the participation in 7-days event, comprising 3-days workshops, a one-day football tournament and a cultural program. Only LGBT identifying persons who were born outside Europe and now live within EU can apply.
By applying and signing the form you agree with being photographed and releasing this pictures to Les Dégommeuses for publication (Internet Site, social networks).

What is your country of origin?

When did you arrive in Europe, and where do you live now?

Please introduce yourself (more detailed information on your experience, your projects, ...)

Have you already been playing football? If yes, for how long?

Has football (or any other sport) helped you to overcome limits? If yes, how?

What is your main interest in FOOTBALL FOR FREEDOM ?

First Name:

Last Name:

Date of Birth:

Gender Identity:

Organization:

E-Mail Contact:
Only fill out if you have regularly access to your e-mails. Not having e-mail/skype/phone/postal address does not influence our decision about your application.

Phone-Number:

Skype:

Postal Address:

Country:

Do you have a valid passport?

Passport Number (if you have a passport)

Level of English


(4= very good, 3= good, 2=fair, 1= none)

______________________________



(City, Date, Signature)

PLEASE send this form to us no later than March 21thto the address below.
e-mail: footforfreedom@gmail.com




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