Ime in priimek:

Spol:
—MoškiŽenskiNe želim se opredeliti.

Datum rojstva (aktivnosti so primarno namenjene mladim med 15. in 30. letom starosti):

Telefonska številka:

E-pošta:

Država bivanja:

Vrsta osebnega dokumenta:
—Osebna izkaznicaPotni list

Številka osebnega dokumenta:

Naziv društva ali organizacije:

Moja motivacija za udeležbo na EYE Brežice je (do 1500 znakov s presledki; v primeru, da bo prijav več, kot je razpoložljivih mest, bo to kriterij za izbor):

Aktivnosti EYE Brežice se bom udeležil_a (izberi eno možnost iz spustnega seznama):
—v petek, soboto in nedeljo (od 24. do 26. maja),v petek, 24. maja, in soboto, 25. maja,samo v petek, 24. maja,samo v soboto, 25. maja,samo v nedeljo, 26. maja.

PAZI ZDAJ! Za vsak dan in časovni termin v nadaljevanju v spustnem seznamu izberi, katere od aktivnosti, ki bodo na EYE Brežice potekale vzporedno, se želiš udeležiti. Ker je v vsaki aktivnosti omejeno število mest, te prosimo, da za vsak dan in časovni termin izraziš tudi svojo drugo željo glede udeležbe na aktivnosti. Gre za to, da te lahko za primer, če tvoja prva izbira ne bi šla skozi, umestimo v drugo. Če se slučajno zgodi, da tudi druga želja ne bo šla skozi, boš razporejen_a v eno od aktivnosti s prostimi mesti.
Vse aktivnosti so opisane v programu – tukaj.

V primeru, če bo aktivnost potekala v angleškem jeziku, lahko brez ovir sledim.
—Da.Ne. Potrebujem prevajanje v slovenski jezik.

Potrebuješ tolmačenje v slovenski znakovni jezik?
—Da.Ne.

Osrednje aktivnosti na EYE Brežice potekajo od petka, 24. maja, do vključno nedelje, 26. maja. Tvoja prisotnost v prijavljenih dnevih je za zagotovitev kakovosti izvedbe aktivnosti obvezna.
Če nisi doma v Brežicah ali bližnji okolici, ti bomo v celoti pokrili_e stroške nočitev z zajtrkom. Stroški poti v Brežice in vrnitve domov so v celoti v tvoji domeni. Nastanitve bodo na voljo v Hotelu Čatež v dvoposteljnih sobah. Izberi, če potrebuješ nočitev in za katere dni:
—Da, potrebujem 2 nočitvi in sicer od petka, 24. maja, do nedelje, 26. maja.Da, potrebujem 1 nočitev in sicer od petka, 24. maja, do sobote, 25. maja.Da, potrebujem 1 nočitev in sicer od sobote, 25. maja, do nedelje, 26. maja.Ne, hvala, nočitve ne potrebujem.

V primeru nočitve ti lahko zagotovimo zajtrk. Označi, če ga želiš:
—Da, prosim.Ne, hvala.Ne koristim nočitve.

Tekom udeležbe na EYE Brežice ti lahko ne glede na to, če boš koristil_a nočitve ali ne, od petka, 24. maja, do vključno sobote, 25. maja, zagotovimo večerjo. Označi, koliko večerij boš koristil_a:
—Dve - petkovo in sobotno, prosim.Eno - petkovo, prosim.Eno - sobotno, prosim.Ne bom večerjal_a, hvala.

Če imaš, kakšne posebne prehranske potrebe, jih navedi tukaj:

Nam želiš glede svoje udeležbe na aktivnosti sporočiti še kaj?

Z oddajo te prijave potrjujem, da:
so vsi vneseni podatki v tej prijavi resnični;
razumem, da oddana prijava ne pomeni, da je moja udeležba na aktivnosti avtomatsko potrjena;
bo v primeru odobritve prijave moja prisotnost in prisebnost na EYE Brežice 100-% (razen v primeru višje sile, npr. bolezni); v primeru, da temu ne bo tako, razumem, da bom nosil_a tudi finančne posledice;
v primeru odobritve prijave tekom sodelovanja na aktivnostih EYE Brežice ne bom konzumiral_a in posedoval_a alkohola ali prepovedanih drog; v primeru, da temu ne bo tako, razumem, da bom iz programa nemudoma izključen_a in da bom nosil_a tudi finančne posledice;
v primeru odobritve prijave in udeležbe na EYE Brežice ne bom uničeval_a, odtujeval_a ali vandaliziral_a tuje lastnine; v primeru, da temu ne bo tako, razumem, da bom iz programa nemudoma izključen_a in da bom nosil_a tudi finančne posledice;
bom spoštoval_a različnost in da sprejemam osrednje načelo EYE Brežice - ničelno toleranco do nasilja, neenakopravne obravnave, diskriminacije, sovraštva in socialnega izključevanja;
me Mreža MaMa in partnerji projekta lahko kontaktirajo za vse zadeve v povezavi s prijavo aktivnosti dogodka EYE Brežice;
soglašam z uporabo, hrambo in ravnanjem z osebnimi podatki, podanimi v tej prijavi, v skladu z veljavno zakonodajo na področju varovanja osebnih podatkov na slovenski in evropski ravni;
dovoljujem fotografiranje in snemanje tekom svoje udeležbe na EYE Brežice in objavo ter delitev gradiva po kanalih projektnega partnerstva, z mediji in tudi z Evropskim parlamentom. V primeru, da tega ne dovoljujem, bom isti dan oddaje te prijave na mail: info@mreza-mama.si poslal_a sporočilo glede tega.

Name and surname:

Gender:
—femalemaleI prefer not to specify.

Date of birth (the activities are primarily intended for young people between 15 and 30 years old):

Mobile telephone number:

E-mail:

Country of residence:

Type of personal ID document:
—Personal ID cardPassport

Number of personal ID document:

Name of the Association or Organisation:

My motivation for participating at EYE Brežice is (up to 1500 characters with spaces; in case of more applications than available spots, this will be the selection criterion):

I am applying to attend EYE Brežice (choose one option from the drop-down menu):
—on Friday, Saturday, and Sunday (from 24 May to 26 May),on Friday, 24 May and Saturday, 25 May,only on Friday, 24 May,only on Saturday, 25 May,only on Sunday, 26 May.

ATTENTION! Further on, please, select in the dropdown menu for each day and time slot, which of the activities running simultaneously at EYE Brežice you would like to attend. As there is a limited number of available placements in each activity, please also express your second choice for participation for each day and time slot. This is for the case that, if your first choice can’t be granted, we can consider your second choice. If it happens that your second choice also doesn't go through, you will be assigned to one of the activities with available places.
All activities are described in the programme - here.

The spoken language of EYE Brežice will be Slovene, at some activities professional translation to English will be offered, but some might be in Slovene with offered explanation in English. Will you be able to follow the activities regarding that?
—Yes.No.

Do you require interpretation into sign language?
—Yes.No.

The central activities at EYE Brežice take place from Friday, 24 May, until Sunday, 26 May. Your presence on the registered days is mandatory to ensure the quality of activity implementation. If you are not from Slovenia, we will fully cover your accommodation costs including breakfast. Accommodation will be provided at the Hotel Čatež in double rooms. Due to limited budget we can’t cover your travel costs to Brežice and return home, so those are fully your matter. Please indicate, if you require accommodation and for how many days:
—Yes, I will stay 2 nights, from Friday, 24 May, until Sunday, 26 May.Yes, I will stay 1 night, from Friday, 24 May, until Saturday, 25 May.Yes, I will stay 1 night, from Saturday, 25 May, until Sunday, 26 May.No, thank you, I do not need accommodation.

In case of accommodation, breakfast will be provided. Please indicate, if you would like it:
—Yes, please.No, thank you.I’m not staying overnight.

Throughout your participation at EYE Brežice dinners will be provided from Friday, 24 May, until Saturday, 25 May. Please indicate how many dinners you will be taking:
—Two (Friday and Saturday), please.One (Friday), please.One (Saturday), please.I will not be having dinners, thank you.

If you have any special dietary requirements, please specify them here:

Is there anything else you would like to add regarding your participation at EYE Brežice?

By submitting this application, I confirm that:
all information entered in this application is true;
I understand that submitting this application does not automatically confirm my participation at the EYE Brežice;
if my application is approved, my presence and attentiveness at EYE Brežice will be 100% (except in cases of force majeure, such as illness); if I fail to comply, I understand that I will bear financial consequences;
if my application is approved and I get to participate at EYE Brežice, I will not consume or possess alcohol or prohibited drugs; if I fail to comply, I understand that I will be immediately excluded from the programme and will bear financial consequences;
if my application is approved and I get to participate in the EYE Brežice event, I will not destroy, steal or vandalize others' property; if I fail to comply, I understand that I will be immediately excluded from the programme and will bear financial consequences;
I will respect diversity and accept the central principle of EYE Brežice - zero tolerance for violence, unequal treatment, discrimination, hatred and social exclusion;
Mreža MaMa and project partners may contact me regarding any matters related to my application;
I consent to the use, storage and handling of my personal data provided in this application in accordance with applicable data protection laws at the Slovenian and European level;
I allow to be photographed and recorded by video during my participation at EYE Brežice and the publication and sharing of materials within the project partnership communication channels, with the media and the European Parliament. In case I do not permit this, on the same day of submitting this application, I will send a message regarding this to the email: info@mreza-mama.si.