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					                                    Course Title:
ACTIVE - Active Citizenship Training Initiative for Volunteers in Europe
Grundtvig Catalogue Reference No: IT-2010-524-001
Dates: 25th to 29th January 2010 (arrival 24th Jan, departure 30th Jan)
Venue:       Casa Tra Noi
             Via Monte del Gallo, 113
             00165 – ROMA –
             TEL.06/39387355 – 06/39387446
             www.tranoi.it

                                    Pre – Registration Form
     Please fill in this page and send it to us by e-mail (info@seven-network.eu) or by fax (+39 06 8841859)


First name:
Family name:
Nationality:
Date of Birth:
Name and type of organisation:
Postal Address for correspondence:

Tel :
Fax:
E-mail:
                                Language Skills
Mother Tongue: German
Skills in       Reading:        Speaking:                      Writing:
English:
Mark from 1-
low to 5-high
       Your answers to the following questions will be very helpful for us:
Please shortly describe your organization and your position and activity in it




Did you work on intercultural issues before (studies, seminars etc.)? If yes,
please shortly describe them.




How would you like to profit from the course in your future activities?




Does your attendance require specific arrangements?

				
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Description: Course-Title-Orientation-–