Part III. Partner organisation(s) / groups(s)

Please fill in this page for each of your partner organisation(s) / group(s).

Has also applied for this project to its National Agency :

yes

no

unknown

not applicable

A. Details of the partner organisation / group

Name

Street address

Postcode

City

Region

Country

Email

Website

Telephone

Telefax

Person in charge of the project (contact person)

Family name

(Mr/Ms)

First name

Position/function

Email

Telephone

Telefax

B. Profile of the partner organisation / group

Type

organisation or association

group

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)

Please give a short description of the organisation/group (regular activities, member of, etc.):

C. Preliminary agreement of the partner organisation / group

I, the undersigned, on behalf of (repeat the name of the partner organisation / group)

confirm our willingness to participate in the preparation, implementation and evaluation of the youth exchange project (repeat the title of the project as stated in Part I)

as well as our commitment to ensure visibility of the European Union support for the activities and/or the production of materials and to encourage the participants to initiate new youth activities.

Name in capital letters :

Place, date :

Signature :