Application: CRM 2017 If you are a human and are seeing this field, please leave it blank. Fields marked with an * are required Dear applicant, This is the application form for participants of the Caucasus Regional Meeting taking place in Tbilisi, Georgia from 17th to 19th of November 2017. We kindly ask you to fill in the form with the required data. All information is strictly confidential and will be used only in selection process for this event. Before submitting the form, please make sure all data is correct. Thank you for your interest in our project and good luck! First Name * Last Name * Gender * Female Male Other Age * Country of residence * City of residence * Nationality Phone number * Email address * Name of your organisation (in English) * Website of your organisation * Email address of your organization * Your role in the organisation * What is the relation of your organisation and CDN/Greens? * Please explain your motivation to participate in this event. What do you expect to get from your participation? * What is a field of activism you are involved/interested in? * Please, explain one challenge for youth activism in your country that you would like to address during the meeting. Is there a good activist practice that you would like to share with the others? * Optional (not a selection criteria): Do you have any dietary and/or accessibility requirements that you wish us to take into account? Estimated travel costs to Tbilisi * I want to pay 10 EUR participation fee if I get selected (not a selection criteria) * YES NO Note: Working language of this project is English. I herewith confirm that the information given in this application is correct and that I will be able to be in Tbilisi from 17th to 19th of November 2017. DEADLINE for submitting this application is 30th October 2017 at Midnight (CET).