Gulliver Connect - Programme

Programme

Application Form Visitor / Application Form Host / Call for application / Guidelines visitor / Guidelines host

First name:
Surname:
	Male Female
Date of birth (dd/mm/yyyy):
Nationality:
Passport Number:

Permanent adress:
City:
Country:
Phone number:
Emailaddress:
Fax:
Website:

Work adress:
City:
Country:
Phone number:
Emailaddress:
Fax:
Website:

1. Briefly outline the activities of the organisation you work for:

2. Please describe your current work position and responsibilities:

3. What other relevant activities (such as performances, exhibitions etc.) have you been involved with during the last few years?

4. In what type of organisation and arts field would you like to have your work placement ?( e.g. a touring dance company or an international theatre festival )

5. How long would you like your placement to last ? (min 3 weeks / max 6 weeks)

6. Please indicate below if you have any preferences for certain dates of the placement

7. Please fill in or check the languages you speak well enough to be able to work with:
Native language:

English
Russian
German
Other:

8. What is your motivation and interest for working in Central or East European country ? (minimum 100 words / maximum 200 words )

9. What will be the practical uses of taking part and how will it relate to your future work ? (minimum 100 words / maximum 200 words )

10. If you have a potential country or host organisation in mind, please give details