Международный Молодёжный Центр "ЗЕМЛЯ - ПЛАНЕТА ЛЮДЕЙ"
ДЕТСКИЙ И СЕМЕЙНЫЙ ОТДЫХ КРУГЛЫЙ ГОД. УНИКАЛЬНЫЕ ПРОГРАММЫ

157800 РОССИЯ, КОСТРОМСКАЯ ОБЛ, г. НЕРЕХТА, ул. СВЕРДЛОВА, д.11, mmc.planeta.nerehta@gmail.com
+7 (49431) 77-336, +7 906 523 39 66, +7 910 9560118, +7 (4942) 36-01-18
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Application for the program "Funny Fences Unior"

 
Your name and surname *:
My friends call me...:
Your photo *:
Your age *:
Date of Birth *:
Mailing address *:
E-mail *:
The name of your school:
Home phone *:
Cellphone *:
Father's name:
Father's contact number(s):
Father's email:
Mother's name *:
Mother's contact number(s) *:
Mother's email *:
Emergency contact (additional) *:
Last couple of years, how did you spend summer vacations?:
What do you expect from the program Funny Fences Unior? *:
Is there any type of activitiy you'd prefer not to particiate? *:
Do you have any health conditions? Do you need to take medications? *:
Are you allergic against something?:
Can you swim?:



Have you been to IYC "Earth Planet of People" before?:


What languages do you study?:
In what kind of sports are you engaged?:
How do you spend your free time?:
When you're with friends, what do you do together?:
What do you like at school?:
Do you play music? If so - what instrument?:
What kind of music do you like?:
What would you like to learn in the IYC? *:
Have you been to summer camps? What kind of? What did you like there?:
Do you have any concerns relating to participation in the program?:
If you want to add something, we'll be glad to read any comments.:
Motivation letter *:




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