APPLICATION FORM

25 th Anniversary of the Founding of the Alps-Adriatic Working Community, Youth Conference

10–12 October 2003, Novo mesto, Slovenia

Participant's details

FIRST NAME _______________________ SURNAME________________________

ADDRESS _________________________________________________________

TOWN/CITY _________________________ POSTCODE______________

COUNTRY ­_________________________

Tel (mob): __________________ E-Mail _________________________

AREA OF STUDY:

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EMPLOYMENT DETAILS:

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DATE OF BIRTH _____________________

I require vegetarian food (please circle): YES NO

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Details on organisation

NAME OF ORGANISATION ______________________________________________

ADDRESS ____________________________

Tel ________________________________

E-mail ____________________

DATE _____________________

DEADLINE FOR APPLICATIONS: 1 October 2003