International Federation of Hard of Hearing
Young People (IFHOHYP)
Study session
“Safeguarding Human Rights of youth
with hearing disability - how to cope with violence and discrimination in
education and employment”
European
Youth Centre
23-30 April, 2006
APPLICATION FORM
(Please type
or use CAPITAL letters and write legibly; be concrete)
Surname:
First name:
Nationality:
Age:
Sex: Male ¨
Female ¨
Full
Address (Please note: all correspondence will be sent to this
address - please ensure it is complete):
Telephone home: Telephone
work:
Telefax: e-mail:
National/local organisation:
Address of
your organisation:
Telephone:
e-mail:
Telefax:
Your
position or responsibilities in your organisation:
Your
experiences in activities/work related to hard of hearing people:
What
kind of projects involving hard of hearing people on local, regional or
international level have you participated in?
Please explain.
Your
interest and experience in the theme of this study session:
What is
your motivation to take part in this study session? Please explain.
What are
your needs and expectations for this study session? Please be concrete and
specific as much as possible.
What
concrete contribution (human rights knowledge, self-esteem exercises, conflict
resolution, project management, application writing skills, legislation
knowledge, etc…) can you make to the study session?
How do you
plan to use the skills and knowledge gained at this study session in your
organisation?
What kind
of project do you think you can undertake after the study session in your
organisation or community?
Are you
hard-of-hearing?
Yes ¨ No ¨
Are you
interested in taking part in the IFHOHYP Multimedia production project and stay for the Preparatory meeting on May
1/ May 1-2? Why? Please explain.
How do you
think you can contribute to the IFHOHYP Multimedia production project? Please
be concrete and specific as much as possible.
You
need to be able to understand and speak in English in order to participate in
this study session. Your other working languages
(please mention all languages you are able to work in):
French
¨ German
¨ Spanish ¨ Russian ¨
Other
languages (please specify):
Do
you have you any special needs or requirements (e.g. dietary, disability, etc.)
If you are accepted, will you be able
to attend the entire duration of the study session?
No
¨ Yes ¨
If no, please indicate the reasons and duration for any
absence:
VISA REQUIREMENTS AND REQUESTED INFORMATION
If you are accepted as a participant of
this course, will you require assistance in obtaining a visa for
If yes, please indicate:
Date and place of birth: Passport
No.:
Issued at (place):
on (date): Date of expiry
Address in passport (if different from home address):
FAX number of French embassy in your country:
TRAVEL COSTS to/from
Please estimate your travel costs to and from
Means of transport (airplane/train/bus)
____________________________
Date: Signature
of applicant::
Signature of organisation:
This
form must be sent to
by
March 5
Should
you have any further questions concerning this study session please feel free
to contact the course director
Karina
Chupina, karina.chupina@gmail.com or team member Yana Domuschieva at yana.domuschieva@gmail.com
SEE MORE ABOUT IFHOHYP AT WWW.IFHOHYP.ORG!