Call for applications Ukraine Lab 2 Personal Information / Your Organisation / Motivation / Additional Information Question Title * 1. Contact Information Name and surname: * Date of birth: * City/Town: * Country: * Email Address: Phone Number: Question Title * 2. Gender Female Male Question Title * 3. Name of your organisation / initiative group Question Title * 4. Homepage of your organisation or official page/group on a social network Question Title * 5. Short description of your organisation / initiative group Question Title * 6. Your motivation for participating at the Ukraine Lab 2.Your expectaions and your burning questions for the discussions. Question Title * 7. Please give concrete exemples of innovative / cross disciplinary / cross sectoral practices of your work / organisation, which you would like to present at the forum. Question Title * 8. I can take part during the whole forum periode 20-24.09.2015 Yes No Other (please specify) Question Title * 9. Where did you find about the Ukraine Lab from? Facebook Friends / colleagues Dialogue for Change web page Newsletter Other Other (please specify) Next
