Please select which chapter and venue:*
AtWork New York (USA) - 300€AtWork Libreville (Gabon) - 150€AtWork Venice (Italy) - 300€AtWork Maputo (Mozambique) - 150€AtWork London (UK) - 300€

Address:*

Please select your profession:*
StudentArtistDesignerMusicianTeacherYouth workerFacilitatorProgram LeaderMentorTrainerOther

Other

Age:*

What are you hoping to learn from this educational experience (max 1200 characters):*

0

Biography (max 1200 characters):*

0

Letter with your personal interpretation of the theme I HAD A DREAM (max 1200 characters):*

0

Letter of intention (max 2000 characters):*

0

Upload your file if you want to add an image in support of your personal interpretation of the theme (zip for more than one):

Acceptable file types extensions are: jpg, jpeg, png, gif, pdf, zip. Acceptable file size is 1 MB (1048576 bytes).

If selected, do you give permission for Moleskine Foundation to use photos or videos of you participating in this workshop for pubblication on the At-Work .org online platform and social media dissemination?*

YesNo

If no, specify why (max 400 characters):

0

If selected, do you authorise the publication of the extracts and/or visuals of your motivational letter for the purposes of communicating the AtWork format in press publications and on Internet websites and social media channels?
The materials will be used under a CC BY-SA (creative commons licenses share alike) licence. The materials are to be held in the archives of the Moleskine Foundation as well as in those of the Country Partner.*

YesNo

If no, specify why (max 400 characters):

0

Following to the workshop, would you allow your name and email address to be included on a mailing/contact list to be distributed to the workshop participants?*

YesNo

How did you hear about AtWork educational format?*

Moleskine Foundation newsletterMoleskine Foundation websiteAt-Work.org platformFacebookFriend/ColleagueSearch EngineOther

If other, specify (max 400 characters):

0

Stay up to date on the AtWork Community, upcoming chapters, personal stories of AtWork experience and Moleskine Foundation initiatives.

Please check this box to receive our newsletterIn compliance with the GDPR and the Italian Legislative Decree no. 196 dated 30/06/2003, I hereby authorize you to use and process my personal details contained in this document*
Privacy policy.

The participant fee is €300 or €150 per person, depending on the chosen chapter.
Moleskine Foundation will provide a number of scholarships for each chapter that will cover the participation costs. To apply for a scholarship check the box below. Please note that travel and accommodation will be at the participants’ expense. If you are selected, you will receive the letter that will confirm your acceptance to the workshop. In case you agreed to pay your participation fee, you will find the link to the Terms and Conditions of payment within the acceptance letter.

Do you need a scholarship?*

Please check this box if you need a scholarship that will cover your participation feePlease check this box if you can cover your participation fee yourself or have a sponsor. The money collected from paying participants will be used to cover scholarships for participants with no funds available, thus guaranteeing wider access to the AtWork experience.For AtWork Venice only. Please check this box if you are a beneficiary of international protection permits (refugee status and subsidiary protection) or asylum seekers and you need a scholarship that will cover your participation fee and your travel and accomodation expenses.

Important info:

Please look out for an email that will confirm that you have submitted your form correctly and that we have received your request for participation. If you don’t receive the confirmation email within 2 hours please check your spam folder before taking any further action.
In case you are selected you will receive an email from us and will be asked to confirm your desire to participate by clicking on the link.