Współpraca zamiast rywalizacji – wymiana dobrych praktyk z działalności młodzieżowych rad miast Chorzowa i Tarnopola

Part III. Partner Organisation (-s) Declaration

Part III must be completed, signed and stamped by your partner organisation from Poland/Ukraine. Original or fax/scan must be submitted with application form.

Details of the Partner Organisation [1]

Name* (national language)

Name* (English language)

Street address

Postcode

City

Region

Country

Email

Website

Telephone

Telefax

Person in charge of the project (contact person)

Family name (Ms/Mr)

First Name

Position/function

Email

Telephone /

Telefax

Legislative representative of the Organisation

Family name (Ms/Mr)

First Name

Position/function

Email

Telephone /

Telefax

Profile of the partner Organisation

 FORMCHECKBOX FFFFFFFF0100000000000000000000000000000000000000000000000000000000000000    Local

 FORMCHECKBOX FFFFFFFF0100000000000000000000000000000000000000000000000000000000000000   Regional

 FORMCHECKBOX FFFFFFFF0100000000000000000000000000000000000000000000000000000000000000   National

 FORMCHECKBOX FFFFFFFF0100000000000000000000000000000000000000000000000000000000000000   Educational institution

 FORMCHECKBOX FFFFFFFF0100000000000000000000000000000000000000000000000000000000000000    Public Institution

 FORMCHECKBOX FFFFFFFF0100000000000000000000000000000000000000000000000000000000000000    Non-govermental organisation

Please give a short description (approximately 800 characters) of organisation (regular activities, member of, etc. ).

Partnership

Please describe your activity and your experience with Your partner organisation.

Declaration on honour of partner organisation

I, the undersigned, on behalf of (repeat the name of the your Organisation)

…………………………………………………………………………..

…………………………………………………………………………..

Confirm our participation in each stage of the project (repeat the title of the project as stated in Part I)

Wspó ł praca zamiast rywalizacji – wymiana dobrych praktyk z dział alnoś ci mł odzież owych rad miast Chorzowa i Tarnopola

(cooperation instead of competition – exchange of good practices from the activities of youth councils of Chorzow and Tarnopol)

Furthermore, I confirm:

 FORMCHECKBOX FFFFFFFF0500000000000000000000000000000000000000000000000000000000000000   fair and reliable work with partner organisation in every stage of the project;

 FORMCHECKBOX FFFFFFFF0500000000000000000000000000000000000000000000000000000000000000  fair use of money send by Partner Organisation and account for the costs financed by the Fund;

 FORMCHECKBOX FFFFFFFF0500000000000000000000000000000000000000000000000000000000000000  I shall not withdraw from the project without notice and without a good reason;

 FORMCHECKBOX FFFFFFFF0500000000000000000000000000000000000000000000000000000000000000  to ensure visibility of the Polish-Ukrainian Youth Exchanges Council support for the project and to ensure dissemination of its results.

 (tick relevant squares)

Name of Legal Representative in capital letters:

Place:

Signature and stamp of organisation:

Date:                                                                                                                                                                             

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