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Youth Mobility Application

Program for young people aged 16 and 17. The form takes about 15 minutes. A parent or legal guardian must fill it in with the participant.

1The participant
2Parents or guardians
3Emergency contact
4Health
5Profile and motivation
6Consent and signature

Step 1 of 6

The participant

Last name

First name

Date of birth

Gender

Full address

City, province, country

Phone

School and grade

Languages spoken

Valid passport? YesNo, application in progress

Parents or guardians

Parent or legal guardian 1

Full name

Relationship to participant

Phone

Parent or legal guardian 2 (optional)

Full name

Phone

Emergency contact

Someone other than the parents, reachable at all times during the stay.

Full name

Relationship to participant

Phone

Health

This information stays confidential and is used only to keep the participant safe.

Allergies (food, medication, other) and reaction

Health conditions to report

Medication taken regularly

Dietary restrictions

Travel insurance

Profile and motivation

Why do you want to take part in this program?

What would you like to share about your own culture?

Documents (passport, photo, vaccination record) – PDF, JPG or PNG, 8 MB max. each

Consent and signature

I authorize my child to take part in the Youth Mobility program and to travel as part of it. In an emergency, if I cannot be reached, I authorize the supervising team to obtain any necessary medical care. My child and I agree to follow the program's code of conduct. I authorize the use of photos of my child for communication purposes (optional).I certify that the information provided is accurate and complete.

Parent or guardian name (signature)

Participant name (signature)

Fields marked with * are required. Prefer paper? Download the PDF application.