Formulaire Action 2 - Expression of Interest en anglais

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Revision as of 23:13, 6 March 2010

1 Part I. Project identification
2 Part II. Host organisation
3 Part III. Project description
4 Part IV. Signature

Part I. Project identification

Title of your proposed projects Please give a short title to your projects.

Type of activity Please tick one or both boxes corresponding to the type of activity for which you are submitting this expression of interest.

long-term voluntary service (6 to 12 months)
short-term voluntary service for volunteers with fewer opportunities (3 weeks to 6 months)

Specific reference to Inclusion (if applicable) Please tick the corresponding boxes, if planned activities shall be related to Inclusion projects.

Placement for volunteers with fewer opportunities (educational, social, economical, cultural, geographical)
Placement for disabled volunteers

Partnership Please give information, if planned activities are open to new partner organisations.

The host organisation is open to working with any partner.
The host organisation only wishes to work within its established networks.

Context of this host expression of interest (if applicable) This expression of interest shall replace the EVS host project approved under this reference number : 810655692548164578253903

902717355454

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Part II. Host organisation

A. Details of the host organisation Please give details on the organisation in which the voluntary service will actually take place.

Name
Street address
Postcode
City
Region
Country
Email
Website
Telephone
Telefax

Legal representative
Family name (Mr/Ms)
First name
Position/function

Person in charge of the projects (contact person)
Family name (Mr/Ms)
First name
Position/function
Email
Telephone
Telefax

Profile of the host organisation Status:

governmental / public
non-governmental
other

Activity level:

local
regional
national
international
European level non-governmental organisation
(with member organisations in at least 8 Programme countries)

B. Details of the contact point (if different from the host organisation) Please indicate contact details here in case you intend to involve another organisation in your country (i.e. coordinating organisation) as contact point for information and partner finding purposes. Your Host Expression of Interest will be published with these contact details only.

Name
Street address
Postcode
City
Region
Country
Email
Website
Telephone
Telefax

Person in charge of the projects (contact person)
Family name (Mr/Ms)
First name
Position/function
Email
Telephone
Telefax

Profile of the organisation Status:

governmental / public
non-governmental
other

Activity level:

local
regional
national
international
European level non-governmental organisation
(with member organisations in at least 8 Programme countries)

Part III. Project description

Please consult the User’s Guide, chapter D.

Main themes for the activities

Please tick not more than 2 boxes.

Art and culture
Social exclusion (in general)
Environment
Measures against delinquency
Heritage protection
Youth information
Rural development
Youth policies
Urban development
Youth leisure
Equal opportunities
Youth sports
Anti-racism/xenophobia
Media and communications
Local Community
Health
European awareness
Other – specify :
Anti-drugs/substance abuse
Other

Main target groups

Please tick not more than 2 boxes.

Youth and children
Elderly
Disabled people
Homeless
Unemployed
Migrants

Validity of the expression of interest

Please tick one box only.

This expression of interest is valid for the maximum period of 3 years after approval.
This expression of interest is no longer valid after (specifiy date up to 3 years) :

Description of project environment, activities and target group

The points below are intended to serve as a guide for your description of proposed activities. Please present your information in the sections on the following page.

A. Project environment:

profile of the organisation, regular activities and local community

Please present briefly the philosophy and regular activities of the host organisation. Add information about the staff, volunteers and/or members of your organisation as well as target group of the activities.
Outline the project environment for the suggested voluntary activities, including the local community where the project will take place (e.g. geographical, social and economical environment).
If you have, please describe your experience with YOUTH/EVS, volunteering and/or voluntary service.
If the host placement is located in a live-in community, please include the rules and conditions that apply also for the volunteer.

B. Proposed activities for international volunteers

Please summarise the motivation of your organisation to host international volunteers.
Describe what you can offer to volunteers in terms of service and learning opportunities. Explain what will be the role of international volunteers in the host organisation.
Describe the activities in which the volunteers could be involved and the activities the volunteers could create in your organisation. Give examples of typical activities for the volunteers.

C. Target group

Please describe the volunteers you would like to receive in your organisation. Include information on the interests they could have. Consider further information about the type of sending organisation you want to cooperate with. This information can help the match-making between volunteer candidates, sending organisations and your organisation.

D. Special needs (if applicable)

If your projects are open to hosting volunteers with fewer opportunities (i.e. facing educational, social, economical, cultural or geographical obstacles and/or to disabled volunteers), please provide information about the competence, experience and infrastructure and (human or other) resources available in your organisation to accommodate and support them. Please note that hosting volunteers with special needs can refer both to short-term and long-term placements.

Part IV. Signature

We, the undersigned, certify that all information contained in this Host Expression of Interest is truthful and accurate and that no relevant information has been withheld. By signing this document the promoter authorises the National Agencies and the European Commission to publish and to use all data provided in this Host Expression of Interest in any form and medium, including the Internet. The data, on paper or electronically, will always be used respecting the privacy of individual persons. The parties undertake to inform the National Agencies of all changes concerning the host project.

For the host organisation

Name of the organisation :
Name of the legal representative in capital letters :
Position/function :
Place, date :
Signature :

For the contact point (if different from the host organisation)

Name of the organisation :
Name of the legal representative in capital letters :
Position/function :
Place, date :
Signature :

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