Reserve Your Place Reserve Your Place Secure your Place now by completing this form!Instructions Please reserve your place at the selected course by entering your personal data below. Please note that a place will be reserved for you with no fee. The participation has to be confirmed 2 weeks after the official announcement of the Erasmus+ KA 1 results by your National Agency.Personal Information of ParticipantTitle Mr.MrsMissMsDr.Prof.First Name *Last Name *Position at School/Organisation *Email Address *Phone No. *Organisation InformationOrganisation Type *Nursery SchoolPrimary SchoolSecondary SchoolTechnical and Vocational SchoolHigher EducationYouth OrganisationYouth OrganisationOtherIf other, please specify. Organisation Name Organisation Address *Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeAfghanistanAlbaniaAlgeriaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCentral African RepublicChadChileChinaColombiaComorosCongo (Brazzaville)CongoCosta RicaCote d\'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast Timor (Timor Timur)EcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceGabonGambia, TheGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKorea, NorthKorea, SouthKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayOmanPakistanPalestinian TerritoryPalauPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint VincentSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of AmericaUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamWestern SaharaWestern SamoaYemenZambiaZimbabweCountryCourse InformationInstructions Select one of the following options depending on your course preference.Select Course for 2018 - 2019: EA1 - Erasmus+: The secrets of successful proposals KA2 - 3/12/2018-8/12/2018EA1 - Erasmus+: The secrets of successful proposals KA2 - 2/12/2019-7/12/2019ICT1 - Technology Tools for Educators - 24/9/2018-29/9/2018ICT1 - Technology Tools for Educators - 9/12/2019-14/12/2019ICT1 - Technology Tools for Educators - 23/9/2019-28/9/2019ICT2 - Social Media for Educators - 8/10/2018-13/10/2018ICT2 - Social Media for Educators - 21/10/2019-26/10/2019ICT3 - Office for Educators - 11/11/2019-16/11/2019ICT4 - Webpage Design and Evaluation for Educators - 19/11/2018-24/11/2018ICT4 - Webpage Design and Evaluation for Educators - 25/11/2019-30/11/2019ICT5 - Internet Security - 19/3/2018-24/3/2018ICT5 - Internet Security - 10/12/2018-15/12/2018ICT5 - Internet Security - 4/3/2019-9/3/2019ROB1 - Robotics for Educators - 2/7/2018-7/7/2018ROB1 - Robotics for Educators - 5/11/2018-10/11/2018ROB1 - Robotics for Educators - 8/4/2019-13/4/2019ROB1 - Robotics for Educators - 10/6/2019-15/6/2019ROB1 - Robotics for Educators - 1/7/2019-6/7/2019ROB1 - Robotics for Educators - 26/8/2019-31/8/2019ROB2 - RoboKIT - 16/4/2018-21/4/2018ROB2 - RoboKIT - 27/8/2018-1/9/2018ROB2 - RoboKIT - 8/7/2019-13/7/2019ROB3 - Robotics for Youth - 3/9/2018-8/9/2018ROB3 - Robotics for Youth -2/9/2019-7/9/2019Other Options: Require Travelling GuidanceRequire Airport TransportationRequire Accommodation AssistanceParticipation in Cultural EventsComments/Special Requirements/Special Support: Privacy PolicyPrivacy Policy *I give my consent for Emphasys Centre to store the above information for contacting me for the course I have requested and also informing me by email for new available courses. VerificationPlease enter any two digits *Example: 12This box is for spam protection - please leave it blank:
