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YOUTH LEADERS AGED 19 AND OVER – REGISTRATION
YOUTH LEADERS AGED 19 AND OVER - REGISTRATION / ESF ANNEX 1 FORM
NAME AND SURNAME
*
I.D. NO:
*
DATE OF BIRTH:
*
DD
MM
YYYY
PERSONAL ADDRESS:
*
Street Address
Address Line 2
City
County / State / Region
ZIP / Postal Code
EMAIL ADDRESS:
*
MOBILE NUMBER:
*
NAME OF ORGANISATION:
*
VO NUMBER OF VOLUNTARY ORGANISATION:
Applicable only for Voluntary Organisations
DESCRIBE THE WORK OF YOUR ORGANISATION
*
Very briefly (maximum 100 characters)
WHAT IS YOUR ROLE IN THE ORGANISATION
*
Describe briefly your youth leadership role in your organisation
AGE GROUP
*
15 - 24
25 - 54
55 - 64
GENDER (As per ID card)
*
Male
Female
RESIDENCE (As per ID card)
*
Malta
Gozo
NATIONALITY
*
YES
NO
Are you a migrant, a person with a foreign background or minorities (including marginalised communities such as the Roma)?
EMPLOYMENT STATUS
*
Employed
Self-Employed
Employed [Persons should be working on a part-time or full-time, or on reduced hours. Persons in “subsidised” employment should also be considered as employed. Persons currently on maternity leave should also be considered as employed.]
EDUCATIONAL BACKGROUND
*
O Levels / school leaving certificate
A Levels
Currently completing / completed Diploma Level 4
Currently completing / completed Diploma Level 5
Currently completing / completed First Degree Level 6
Currently completing / completed Masters Level 7
Currently completing / completed PhD Level 8
Are you a disabled person?
*
YES
NO
Are you enlisted in one of the following*?
*
YES
NO
* A registries: (i) Commission for the Rights of Persons with a Disability; (ii) social security for the participants benefiting from disability benefits; (iii) Jobs Plus?
If you marked yes in the previous question, please write your registration number and entity with which you are registered:
Do you have any other disadvantages?
*
YES
NO
Tick yes if one or more apply: (i) ISCED level 0; (ii) homeless or effected by housing exclusion); (iii) inmates or former offender; (iv) former substance abusers or undergoing detoxification treatment; (v) at risk of poverty.
Do you live in a single adult household with dependent children?
*
YES
NO
Are you living in the following circumstances: rooflessness, houselessness, insecure accommodation, and/or inadequate housing?
*
YES
NO
Download the Terms and Conditions using the link below, print, sign, scan or take a photo and upload
*
Download T&C
Mark your Training Group
*
YL Group 5 - St Patrick's Sliema
YL Group 1 (This group is closed)
YL Group 2 (This group is closed)
YL Group 3 (This group is closed)
YL Group 4 (This group is closed)
The courses are organised in groups of 15 to 20 participants. The calendar displays the group number. Mark which group you prefer to join according to your preferred dates. The courses are titled Youth Leaders 19+ (YL Group 1, 2 ,3 and 4). Group 1 is fully booked. Please select only from Groups 2, 3 or 4