http://www.eap.pauci.org/file/ZWFwX3BhdWNpX2ZpbGVzMjY1NQ__

European Commission – External Relations http://ec.europa.eu/external_relations/eastern/civil_society/index_en.htm 28/05/2010 Application form Expression of interest to participate in the second meeting of the Eastern Partnership Civic Society Forum 1. Organization name and its legal status ………………………………………………………………………………………………… …………………………………………….. ………………………………………………………………………………………………… ……………………………………………..

2. Location (1) EaP country …………………..

(3) International organization, network (4) Third country

(2) EU member state……………

3. Main sources of funding ………………………………………………………………………………………………… ………………………………………………………………………………………………… …………………………………………………………………………………………..

4. Spheres of activity (choose max two) (1) Media

(8) Business, professional associations

(2) Education, research

(9) Trade unions

(3) Health care, social services

(10) Community base, municipal and local activities

(4) Environment, energy

(11) Culture, recreation

(5) Human rights, democracy, rule of law

(11) Youth and family

(7) Charity, religion

(12) Other…………………………………

5. Which working group of the CSF would you like to participate in? (choose only one) (1)Democracy, good governance, stability, border management (2)Economic integration, convergence with EU policies 1

European Commission – External Relations http://ec.europa.eu/external_relations/eastern/civil_society/index_en.htm 28/05/2010 (3)Energy, climate change, environment (4)Contacts between people 6. Which sub working group at the CSF would you like to participate in?∗ (choose only one) (1)Free movement of people (2) Public administration reform (3) Anti corruption (4) Independent media (5) Judiciary reform (6)Energy (7) Environment (8) Fight against poverty (9) Education and Youth development (10) EaP monitoring, think tank cooperation (11) EaP CSF strategic thinking (12)Other…………………………… ……………

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7. Participation in the previous Forum’s meeting:

Yes No

8. Has your organization been involved in any activities related to cooperation between EaP countries and the EU? If yes, please indicate the most important initiatives (max 100 words). …………………………………………………………………………………………… …………………………………………………………………………………………… …………………………………………………………………………………………

9. Why is your organization interested in participation in the SCF 2010? (max 100 words) ................................................................................................................................. ................................................................................................................................. ..........................................

10. Describe the capacity of your organisation to act as a multiplier in generating debate and disseminating information on EaP­relevant issues (max 100 words). ................................................................................................................................. ................................................................................................................................. ..........................................

Full name and signature:

Personal data protection Expression of interest in the Eastern Partnership Civil Society Forum will involve the treatment by the Directorate General RELEX of personal data concerning the participant, in accordance with Regulation (EC) No 45/2001.

By filing the above form, the applicant will be considered as having given his or her consent to the processing of these data in the context of this invitation. These contact information might be later distributed among the participants of the EaP Civil Society Forum, unless invited participants object to the publication of their contact details. The list of CSOs which applied to participate and the list of CSOs which were invited could be put on the website.

With a view to the provisions of the said regulation, furthermore, the following should be noted: Identity of data controller: DG RELEX, European Commission Purpose of the processing operation: all handling needed for the applicant’s eventual participation at the Eastern Partnership Civil Society Forum and drafting a global list of participants which might be distributed at the Forum.

Right of access: Applicants have a right to access their data.

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Sub-groups will become operational at the meeting in November or later on in the course of regular activities of the EaP CSF.