Application form Title MrMrs/Ms First name Last name Date of birth Place of birth Email address Phone number Nationality Educational background Affiliation (name of the institution) Affiliation (address of the institution) Current position Do you have any experience related to the scope of the workshop. Describe it briefly. As a part of the project you will be asked to deliver at least one follow up event for your local community. How will you organise it? Describe it briefly. How did you learn about the workshop? * I hereby give consent for my personal data to be processed for the purposes of the ref:EU | Muslim minorities and the refugee crisis in Europe project and the accompanying activities (e.g. a conference), in accordance with the Polish Personal Data Protection Act dated 29.08.1997 (Journal of Laws of the Republic of Poland 2002 No 101, item 926 with further amendments). I hereby declare that I am aware that I am entitled to review and correct my personal data. * I hereby give consent for the documentation of my image during the workshop organized within the ref:EU project and the accompanying activities, encompassing i.a. photographing, filming, video and audio recording, Internet streaming, free of charge publishing and its use in promotional, information and dissemination activities within the ref:EU project. * I hereby understand that I will be obliged to organise at least one follow-up event for at least 25 participants. All fields are required.