Application for:
Action 1 - Youth for Europe
Sub-Action 1.1 - Youth Exchanges
Version valid as of 1 January 2009
Please fill in all relevant sections of this application. It is compulsory to annex ALL documents requested in the check list.
Please consult the Programme Guide to find all the information you need to lead your project and to fill in this application form.
Part I. Project identification and summary
Project number
To be filled in by the Executive Agency or the National Agency
Postmark/Date of receipt
Name of the applicant
OK Lokomotiva Pardubice, občanské
sdružení (LPU)
Please indicate the name and acronym of the applicant.
Title of the project
Please give a short title to the project.
We are ONE TEAM!
Type of Activity
Please tick the boxes corresponding to the exchange for which you are submitting this application. For more information,
please consult Part B, Action 1.1 of the Programme Guide.
This project is a Youth
Exchange of the
following type:
(tick one box only)
bilateral (2 promoters from different Programme Countries1)
The applicant will:
(tick one box only)
host a/several group(s)
trilateral (3 promoters from different Programme Countries 1)
multilateral (at least 4 promoters from different Programme Countries1)
send a group to another country
be Coordinating Organisation of the project2
1
2
At least 1 promoter from an EU country must be involved.
Only for projects submitted at European level and for multilateral and itinerant projects submitted at national level.
Duration of the project3
Please indicate the total duration of the project from preparation to evaluation, and also the start and end dates of the actual
Exchange Activity.
Start date of the project4:
(date when the first costs incur)
01 / 07 / 2009
End date of the project:
(date when the last costs incur)
30 / 11 / 2009
The Activity starts:
26 / 07 / 2009
The Activity ends5:
02 / 08 / 2009
Total duration of the Activity (in days), excluding travel days :
Venue(s):
Falun and Strömstad, SWEDEN
3
Maximum duration of the project: 15 months.
4
Please consult the part C of the Programme Guide ("Respect the deadline").
5
Duration of the Activity: between 6 and 21 days (travel days excluded).
8
Part I. Project identification and summary (cont.)
Relevance to the general objectives of the Youth in Action Programme
Please tick relevant box(es).
The project:
promotes young people’s active citizenship in general and their European citizenship in particular;
develops solidarity and promote tolerance among young people, in particular in order to foster
social cohesion in the European Union;
fosters mutual understanding between young people in different countries;
contributes to developing the quality of support systems for youth activities and the capabilities of civil
society organisations in the youth field;
promotes European cooperation in the youth field.
Relevance to the priorities of the Youth in Action Programme
Please tick relevant box(es).
Permanent thematic priorities
European Citizenship
Annual priorities
If so, please specify:
Participation of young people
- Intercultural dialogue
Cultural diversity
- Sport as a tool to promote active
citizenship and social inclusion of
young people
National priorities
If so, please specify:
Inclusion of young people with fewer opportunities
Main themes for the Activity
Please tick not more than 2 boxes.
European awareness
Minorities
Social inclusion
Urban/Rural development
Inter-religious dialogue
Youth policies
Anti-discrimination
Media and communications/Youth information
Art and culture
Education through sport and outdoor activities
Gender equality
Health
Disability
Environment
Non-discrimination based on sexual
orientation
Roma Communities
Other - If so, please specify: Stereotypes
Youth in Action Programme – Sub-Action 1.1 - Youth Exchanges
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Summary of the project
Please give a short description of your project (approximately 10-15 lines). Please note that if your project is approved, this
paragraph may be used for publication. Therefore be accurate and include the venue, the type of project, the theme, the
objectives, the duration in days, the countries involved, the number of participants, the implemented activities and the methods
applied. This summary should be completed in English, French or German, regardless of which language you use to fill in the
rest of this application. Please be concise and clear.
OK Lokomotiva Pardubice, občanské sdružení (Czech Republic) and OK Kåre in Falun (Sweden)
and are two orienteering clubs which will jointly run a bilateral project “We are ONE TEAM!”, within
the EU “Youth in Action” Programme. All together 30 girls and boys between 14 and 29 years as well
as four leaders will meet in Falun and Strömstad in Sweden and during 8 days cooperate in different
activities connected to two main themes:


Education through sport and outdoor activities, including orienteering
Stereotypes (based on different culture, gender, age…)
The main objectives are to develop social competence with mutual learning and understanding of
different cultures, enhance self-confidence and in the end perform as one team regardless of
nationality, age or gender.
The exchange builds upon non-formal learning and learning by doing methods including activities
such as country presentations; outdoor games developing communication skills, trust and
teambuilding; Czech-Swedish movie/workshop evenings about stereotypes.
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Part II. Applicant
A. Details of the applicant
Name
OK Lokomotiva Pardubice, občanské sdružení
Street address
Palackého 2547
Postcode
530 02
City
Pardubice
Region
Pardubický kraj
Country
Czech Republic
Email
[email protected]
Website
http://lpu.cz
Telephone
+4204665410154
Telefax
+4204665410154
Person authorised to sign the contract on behalf of the applicant (legal representative)
Family name (Ms/Mr)
Klimpl
Position/function
Chairman
First name
Petr
Person in charge of the project (contact person)
Family name (Ms/Mr)
Klimplová
Position/function
Project Coordinator
Email
[email protected]
Telephone
+420604627678
Youth in Action Programme – Sub-Action 1.1 - Youth Exchanges
First name
Lenka
Telefax
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B. Profile of the applicant
Type and status
Activity level
Non profit/non
governmental
organisation
Public body
Body active at European level
in the youth field (ENGO)
Other – please specify:
Local
Informal group of young people
National
Regional
European/International
Please give a short description of your organisation/group (regular activities, member of, etc.) and describe your competencies
and motivation to complete the proposed project.
OK Lokomotiva Pardubice, o.s., is an orienteering club with 201 registered members (it is the
biggest orienteering club in the Czech Republic). All age groups are represented in our
organization, from small children in pre-school age up to senior citizens (60 years and older). The
inter-generation dialogue and cooperation is an important aspect in functioning of our organization.
The priority of the club is, however, a work with youth (a 40 years tradition of this activity in our
organization). Examples of actual activities for youth: Youth Sport Centrum (that has been
realized by our organization since 2003) where all youngsters (in this case 15-18 years old) from
small orienteering clubs in Pardubice and Vysočina regions are included, led and supported in
developing their skills (sport skills, social skills, communication skills etc.) by qualified leaders,
Pardubice School League (traditional events since 1970s where orienteering and its values are
presented to youth from all schools in Pardubice and its surroundings willing to actively participate),
Summer Youth Camps (since 1988), and of course qualified leadership in all regular activities
(trainings, camps, social activities). International cooperation with alike focused organization (nonformal learning and experience sharing) can definitely enrich our work with youth.
Has your organisation/group already received a EU grant?
No
Yes - specify funding received or applied for in the last financial year:
Part III. Partner promoter(s)
Has also applied for this project to its National Agency :
Yes
No
Unknown
Not applicable
A. Details of the partner
Name
OK Kåre
Street address
Sjulsarvet 100
Postcode
791 91
City
Falun
Region
Dalarna
Country
Sweden
Email
[email protected]
Website
www.okkare.se
Telephone
+462310072
Telefax
+4623711142
Person in charge of the project (contact person)
Family name (Ms/Mr)
Mattsson
Position/function
Project coordinator
Email
[email protected]
Telephone
+46703987338
Youth in Action Programme – Sub-Action 1.1 - Youth Exchanges
First name Lars
Telefax
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B. Profile and role of the partner
Type and status
Activity level
Non profit/non governmental
organisation
Public body
Body active at European level in
the field of youth (ENGO)
Other – please specify:
Local
Regional
Informal group of young people
National
European/International
Member organisation of the applicant
Role
Sending Organisation
Host Organisation
Please give a short description of your organisation/group (regular activities, member of, etc.):
OK Kåre is an orienteering club established in 1950 with today 381 registered members. All age
groups are represented in our organization, from small children in pre-school age up to senior
citizens. The inter-generation dialogue and cooperation is an important aspect in functioning of the
organization.
The priority of the club is the work with youth. 40 percent of the members are in the ages up to 30
years, with a distribution of 50/50 % male/female. During many years OK Kåre have had
collaboration with the schools in the region with a learning programme where pupils and teachers
learn about nature in connection with exercises in orienteering. Every year Kåre arrange courses
for beginners in ages from 7 to 16 years. Every summer Kåre also organize Summer Youth Camps
(SOL-school) for youngsters from the region.
C. Preliminary agreement of the partner
I, the undersigned, on behalf of OK Kåre
confirm our participation in each stage of the project We are ONE TEAM!
In case of one-sided funding, I declare having reached an agreement with all the promoters involved in the
project with regard to the share of EU grant my organisation/group is entitled to receive in order to implement the
project.
Furthermore, I confirm my undertaking to ensure visibility of the European Union support for the project and to
ensure dissemination and exploitation of its results.
Name in capital letters:
MATS ADOLFSSON
Place: FALUN, SWEDEN
Signature:
Date:23/03/2009
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Part IV. Participants in the project
If more space is needed, please add rows.
A. Information on the YOUNG PEOPLE directly involved in the project
Please give information about the composition of the group of young people by country of residence participating in the project
(not including the group leaders).
Total
number of
young
people6
Name of the
promoter7
Czech Republic
Sweden
Country of residence
Subtotal
6
Distribution by
gender
Distribution by age group8
M
F
13-14
15-17
18-25
26-30
14
OK
Lokomotiva
Pardubice,
o.s.
(Sending
Org.)
9
5
1
5
7
1
16
OK Kåre
(Hosting
Org.)
8
8
-
8
8
-
30
From 16 to 60 participants - minimum 8 participants per group (for a bilateral Youth Exchange), minimum 6 participants per
group (for a Trilateral Youth Exchange) and minimum 4 participants per group (for a Multilateral Youth Exchange).
7
Please specify whether it sends or hosts participants.
8
Young people aged between 13 and 25 and legally resident in a Programme Country can participate in a Youth Exchange. A
small number of participants may be aged between 25 and 30, at the application deadline.
B. Information on the GROUP LEADERS directly involved in the project
Please note that the group leaders should only be mentioned in this table, not in table A.
Total number of group
leaders9
Country of residence
Distribution by
gender
Promoter
M
F
Czech Republic
2
OK Lokomotiva
Pardubice, o.s.
(Sending Org.)
2
0
Sweden
2
OK Kåre (Hosting Org.)
1
1
Subtotal
9
4
Minimum 1 group leader per promoter.
TOTAL of participants (young people and group leaders)
Youth in Action Programme – Sub-Action 1.1 - Youth Exchanges
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34
Part V. Project description
The points below are intended to serve as a guide for your description of the proposed activities. The information that is
requested will be very important in the selection process, and later for the running of the project. For further information,
please consult the Programme Guide, part B – Action 1.1.
If more space is needed, please extend boxes.
Objectives and priorities:
Please explain the context, the origin and the objectives of your project and in which way it meets the objectives and the
priorities of the Youth in Action Programme.
Context and origin of our project
All participants of the project are connected by the common interest – orienteering and sport in
general. Based on this common interest and shared experience of some of them from the
exchange realized in the previous year (see the box below – the history of our partnership), the
participants are motivated to develop their knowing each others, go on with discovering each
others’ cultures and learning something new from each other.
What is especially of importance, new people have got highly interested in participation in this
youth exchange “infected” by positive feedback and enthusiasm of those who took part in the youth
exchange last year. Therefore more people will be included in the project this year (informal
spreading of splendid experience of last year participants attracted new young people to take part
in).
Participants will be members of both partner organizations (in the case of our organization, we
involve also some members of the Youth Sport Centrum attached to our organization – it means
not only members of our club but also young people from small clubs in Pardubice and Vysočina
regions who would have otherwise only limited opportunities to gain such experience will
participate in). They seem to be willing to actively work on partnership and on achieving objectives
which have been set up in discussion with them.
Objectives and priorities of the project
(Though they are numbered, the objectives are not ranked according to their importance. All
objectives are important.)
1) Learn something new about the others, the other country and its culture which could
encourage mutual understanding between participants as well as start to discuss
stereotypes and prejudices.
2) Young people from different cultural and social background can work together - sharing of
knowledge, experience, skills between participants from different countries.
3) Try to build up “team-spirit” (social cohesion) and perform as ONE TEAM (regardless of
nationality, age or gender).
4) Have fun!
5) Develop orienteering skills of the participants but on the other hand show participants that
orienteering is not the only activity they can do together.
6) Establish a deeper long-term cooperation between the young participants as well as
between the participating organizations behind the time limit and scope of this project.
The objectives are mutually bounded and should encourage each other.
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Partnership, theme and activities:
Please indicate:
 how you found the other promoter(s), how you established an efficient partnership, and how the partner(s) will cooperate
and be involved in the project,
 the theme(s) of the project,
 the activities foreseen throughout the project for its implementation, including preparatory and evaluation activities.
Please attach an estimated daily timetable of the planned Activity.
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The history of our partnership
Cooperation between OK Lokomotiva Pardubice, o.s. (the sending organization) and OK Kåre (the
receiving organization) started in the beginning of the year 2008.
The project coordinator of the sending organization has spent three years in Falun, Sweden – firstly
as a participant of internship, then as an Erasmus student and recently as a university lecturer.
During her stay she has got involved in a life and activities of the receiving organization, OK Kåre,
which has the same focus as OK Lokomotiva Pardubice, o.s. – orienteering and work with youth
(education through sport and outdoor activities).
In the beginning of the year 2008 we started to discuss possible exchange of our youth. 6 Czech
and 4 Swedish young people got interested in the idea to visit each other’s country, live in families
and learn something new about lifestyle in another country. Since only 10 people were interested
in, we did not apply for the Youth in Action grant last year. The both-way exchange (Swedes visited
the Czech Republic for 11 days and Czechs visited Sweden for 9 days) was prepared and
organized by participants themselves but without any beforehand defined objectives.
Our partnership today
The project “We are ONE TEAM!” is based on feedback from the last year exchange and on efforts
to establish a deeper long-term cooperation with the partner organization in youth activities and
youth leadership (sharing and diffusion of experience, knowledge and skills between young people
as well as between their leaders).
Both organizations are equal partners involved in the project since its beginning (we planned this
project and wrote this application together, discussed all details; activities are based on wishes of
participants from both organizations). During the realization of the project none of the partners will
be dominant, we are going to discuss all issues (activities, games, exercises, trips, crisis plan etc.)
together. A division of tasks will be based on such discussion.
The leaders and participants from OK Kåre are nice people, open to discussion, able to solve
problems therefore we are looking forward to our cooperation with them and learning something
new from them.
The themes of the project

Education through sport and outdoor activities, including orienteering

Stereotypes (based on different culture, gender, age…)
Activities
Preparatory activities
Preparatory activities have been running in both participating organizations. The participants got
involved in planning of the project and its activities. Based on feedback from the previous year and
on discussion on expectations of the participants in each organization, the objectives have been set
up and general activities planned.
Communication between partner organizations – via email, via Skype + a personal visit of the
project coordinator of the sending organization in the hosting organization during May is planned.
And also the advanced planning visit is going to be realized before the exchange (see below).
Meetings of all participants in each organization are planned before the exchange where
information about exact times of departure and arrival, about safety issues, about particular
activities, about things and materials to take with etc. will be provided and discussed.
Czech young participants will propose a design of T-shirts with theme of the exchange as well as
with the logo of Youth in Action programme and we will get made T-shirts before the exchange for
all participants from the Czech Republic as well as from Sweden. Swedes will be consulted about a
design of T-shirts via email or Skype/icq.
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Activities during the exchange

Name and ice-breaking activities (few of the participants have already know each other
from last year so they could help “ice-breaking”)

“SWEDEN ≠ IKEA! CZECHIA ≠ PRAHA!” – workshop on dismantling stereotypes

Country presentations – “What do you know about my country?” (history, geography,
authors, films, sport, lifestyle, food etc.)

Czech-Swedish movie evenings (for instance: Účastníci zájezdu – stereotypes about
Czechs, Jalla! Jalla! – stereotypes about minorities, Cops – stereotypes about professions
etc.) followed by discussions about those movies and stereotypes presented there

Czech-Swedish cooking time

Outdoor activities developing different skills:
-
games developing communication skills
-
team cooperation and team building games
-
trust games
-
orientation and orienteering games and exercises

Participation in “Ungdomens 10mila” (Youth 10 miles) – a traditional 10 members (boys)
and 5 members (girls) relay race where the Czech and Swedish participants will run in ONE
TEAM (“team-spirit”)

Visit of FaluGruvan (Unesco World Heritage)

Leisure time activities (aquapark, barbeques)

Workshop on preparation of following activities:
-
How to promote the project and the Youth in Action programme among peers in each
country? (among others, preparation of school presentations and posters, see below)
-
How to go on with this project?

Evaluation of activities during the exchange
Evaluation activities

Evaluation activities at the end of the exchange – e.g. questionnaire with open-ended
answers, to complete sentences in the letter to the leaders, to write yourself a postcard which
will be sent to you a half a year later etc.

Evaluation by the participants in each organization after few weeks after the exchange in a
form of workshop and starting planning following activities between the participants as well
as between the partner organizations (including a new exchange).

Meeting of representatives of both partner organizations in Sweden in October 2009 where
the exchange as well as the whole project is supposed to be evaluated and following
activities between the participants and the partner organizations (including a new exchange)
are expected to be planned.
For an estimated daily timetable of the exchange see the TABLE: PROGRAMME OF ACTIVITIES (in
the attachment)
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Protection and safety:
Please describe how your project ensures the protection and safety of young people involved.
All participants will be informed about safety rules and we will follow these rules (e.g. rules during
swimming, what to do if somebody gets lost during some activity etc.). They will also be informed
about different laws concerning drinking of alcohol in Sweden. A short anti-drug presentation will be
provided (the hosting organization OK Kåre has its own anti-drug plan so all participants will get
familiar with it).
Before the exchange, during the advanced planning visit, we will discuss a crisis plan (what to do
step by step in a case of emergency).
One of the leaders from OK Kåre (the hosting organization) is a doctor so a medical care will be
provided by him. All Czech and Swedish leaders are qualified for work with youth (pedagogical
education and/or coach’s exams).
All participants will be insured.
We arrange a varied diet and check that the participants drink enough during days and all activities.
If sunny weather, we check using of protection sun-block creams/milks.
Advance Planning Visit:
Have you planned an Advance Planning Visit?
If so, please indicate proposed programme, dates and venue10.
Yes
No
The advanced planning visit will take place in Falun (Sweden) from 15th to 17th of July. Two Czech
participants will go there to discuss following issues:
- concrete activities (methods, for instance concrete games) and division of responsibilities for
preparing these activities;
- further specification of daily timetable;
- crisis plan (what to do step by step in a case of emergency, e.g. if somebody gets injured, what
we will do);
- what should be brought by each organization (materials);
- other actual issues.
10
For more details about the eligibility criteria, please refer to Part B – Action 1.1 of the Programme Guide.
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Project’s content and methodology:
Please describe:
 how the main theme reflects the interests and needs of participants,
 the working methods,
 how the planned activities and working methods will contribute to the process of non-formal learning and to the promotion of
social and personal development of young people involved in the project,
 how the young people will be actively involved in each stage of the project.
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Since the participants are bound with the same interest, the theme of “Education through sport and
outdoor activities, including orienteering” reflect very well their expectations. The other theme has
been proposed by the leaders and the participants have agreed it would important and interesting
to go in for it since all of us have got some prejudices and stereotypes about “the others”. And we
want to be ONE TEAM, therefore prejudices and stereotypes should not have any place among us.
A choice of activities reflects the objectives and the main themes and is based on evaluation of
previous cooperation between some of the participants as well as on discussion between last year’s
and new participants on what they want to do and experience during the exchange.
Working methods
We will use methods of non-formal learning. Activities are based on wishes and expectations of the
participants and they focus on experiences with beforehand objectives of each activity (like
developing of communication skills, developing of cooperation etc.). The active involvement of all
participants is an important aspect for us. All of them should cooperate voluntary and understand
why we do a particular activity and how they can benefit from it (what they can learn new, how they
can use learnt skills in future etc.).
We will use games such as ice-breaking games (such as “Gestures”, “A Box of Life”, “Who is
missing?”, “Mission Impossible” etc.), games developing communication skills (such as “Talking
circle”, “Beams”), team cooperation and team building games (such as “Building a raft”, “Monkey trail”
etc.), trust games (such as “Falling in a pair”, “Odd and Even” etc.), orienteering games and exercises
(a “Swiss game”, “Snake” etc.) for developing different skills. Concrete games will be agreed during
the advanced planning visit and then during the exchange based on actual needs and wishes of
participants as well as on actual conditions (weather, etc.).
Furthermore, we will use workshops and moderated discussions after activities (after movies,
cooking, outdoor activities etc.)
Contribution to the process of non-formal learning

Learning by doing – what you experience, you will remember!

Young people will be led to realize difference and similarities between culture and lifestyle in
different countries as well as between individuals.

They will develop their communication and cooperation skills.

“Team-spirit” – getting a feeling that they are members of the international community.
Active involvement of young people in planning, realization and evaluation of the activities

Young people participated in discussions on setting up objectives of the project and they
helped to plan activities for achieving these objectives.

Two of the young participants will go to Sweden for the advanced planning visit to discuss all
details of the exchange described in the box above.

Young people are responsible for planning of T-shirts with theme of the exchange.

Young people are responsible for preparation and realization of some activities and they will
actively participate in all activities.

All participants will be actively involved in evaluation of the exchange and the whole project
and led to propose a possible follow-up.

One/two of the young participants may go to Sweden for the evaluation visit after the
exchange to evaluate the project and its impact and plan following activities and a possible
new project.

Young participants will participate in promotion of the project and the exchange, for instance
by preparing and wearing T-shirts with a motive of the exchange and Youth in Action logo, by
presenting their experience from the project to their schoolmates and to other members from
the sending and hosting organizations, by participating in radio discussions about the project
etc.
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Intercultural dimension:
Please indicate if and how your project reflects the following characteristics:
 the project increases young people’s positive awareness of other cultures,
 the project supports dialogue and intercultural encounters with other young people from different backgrounds
and cultures,
 the project helps to prevent and combat prejudice, racism and all attitudes leading to exclusion,
 the project develops sense of tolerance and understanding of diversity.
Our project is supporting intercultural dialogue. One of the main themes of the project is
“stereotypes”. We will lead young people to start thinking how they think about others – which
features they associate with different nationalities, countries, cultures, minorities. We try to help
them dismantling these stereotypes and show differences as well as similarities between them and
those whom they perceive as “foreigners”. We will try to achieve that by workshops, by watching
Czech and Swedish movies (with English subtitles) followed by moderated discussions, and
through different outdoor activities focused on communication, cooperation and team building. (See
the activities.)
Young people will be led to understand and respect each other though they do not speak the same
language (official language of the exchange will be English but it is not a mother tongue of any of
the participants).
European dimension:
Please indicate if and how your project reflects the following characteristics; tick box(es) and then describe:
the project fosters young people’s sense of European citizenship and helps them to understand their role as part of the
present and future of Europe;
the project reflects a common concern for European society, such as racism, xenophobia and anti-semitism, drug
abuse…;
the project’s theme is linked to EU topics, such as EU enlargement, the roles and activities of the European
institutions, the EU’s action in matters affecting young people;
the project debates the founding principles of the EU, i.e. principles of liberty, democracy, respect for human rights and
fundamental freedoms, and the rule of law.
The theme of EU enlargement is partly involved in our project. Both Sweden and the Czech
Republic belong to ones of new EU member states (Sweden is a member of the EU only 9 years
longer than the Czech Republic).
However, Czechs are still, and often, taken as newcomers from “the east”. One of the main themes
of our project is to start breaking stereotypes and combating prejudices. By getting known each
others, young people will learn they are equal and “the newcomers” from the Central and Eastern
European countries (represented here by Czechs) are “the-same-class” EU citizens as citizens
from the “old” member states.
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Impact, multiplying effect and follow-up:
Please explain the expected impact on young participants and the local communities involved in the project and which
measures are foreseen to attain this impact. In a long term perspective, please describe how you plan to achieve a
multiplying effect and sustainable impact. Please also explain how you plan to follow up this Youth Exchange (e.g. new
projects within the framework of the Youth in Action Programme, continuous contact with the promoter(s), etc.)?
Impact on participants

Developing skills of the participants – communication, cooperation, orientation, orienteering
etc.

Learning something new about the other country and its culture and lifestyle.

Starting to think about stereotypes – accept diversity and respect others.

Getting a feeling: “I am a part of the international group – we are ONE TEAM!”

New relationships and long-term cooperation among the participants (exchange of emails,
skype/icq communication, a common web space - www.myopera.com/loko_Kare…)
Impact on organizations

Learning new approaches and methods in work with youth from each other, sharing of
experience .

Promotion of the project between other age groups in each organization – inter-generation
dialogue.

Long-term cooperation with the partner organization and follow-up projects are considered
(a next exchange in 2010 – Swedes coming to the Czech Republic; possibly a job
shadowing, study visit or seminar under the Action 4.3 of the Youth in Action programme).
Impact on local communities

Presentation on the project among peers of the participants in their schools in each country
(after the exchange) could have positive feedback and impact on active involvement of new
young people in the Youth in Action programme.

Public will get known about the project and about the Youth in Action programme via media
(see the boxes below) and via a poster at the public notice board of our organization.
Youth in Action Programme – Sub-Action 1.1 - Youth Exchanges
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Visibility:
Apart from the compulsory use of the Programme Logo (cfr. Part C, Publicity, of the Programme Guide), please describe:
 how you will ensure the visibility of the project;
 how your project will provide clear promotional added value for the Youth in Action Programme.

Partnership with regional media in both countries are supposed to be established to
promote our project and the Youth in Action programme and inform public:
- The partnership with the Český rozhlas Pardubice has already been agreed – ČRo
Pardubice will cover and publicize all stages of our project
- Other Czech regional media (MF Dnes, Pardubický deník etc.) will be informed by press
releases and provided with photos from the exchange, they will be offered to make an
interview with participants.
- OK Kåre will write press releases and contact local and regional media such as TV, radio
and newspapers like Falu-Kuriren and Dala-Demokraten.

We will inform about the exchange, the project and the Youth in Action programme in
national orienteering magazines – Orientační běh (Czech), Skogssport (Swedish) – and in
magazines of each organization – Jantar (the sending organization, OK Lokomotiva
Pardubice, o.s.) and KåreNytt (the hosting organization, OK Kåre).

We will inform about the exchange, the project and the Youth in Action programme on
web-pages of both partner organizations, we will publish photos from the exchange there
and of course the Youth in Action logo.

T-shirts with a motive of our exchange and the Youth in Action logo will be worn by the
participants.
Dissemination and exploitation of results:
Please give a detailed description of standard measures planned in view to disseminate and exploit the results of the project.

Dissemination and exploitation of results is planned through partnership with Český rozhlas
Pardubice which will cover and publicise all stages of our project (see above) and through
publishing results in other media.

The young participants will organize presentations for their peers (school-mates) in their
schools after the exchange (when the school year starts) to promote the project and its
results and the Youth in Action programme. It could have positive feedback and impact on
active involvement of new young people in the Youth in Action programme.

Moreover, the young participants will organize presentations for the other members of their
home organizations to promote the project and present what they learn new (the results).

The results of the project will be disseminated via web-space
(www.myopera.com/loko_Kare) too.
Have you planned additional measures assuring dissemination and exploitation of project's results?
Yes
No
If so, please describe them.
Posters
We make few posters presenting project’s result which will be used during presentations at schools
and one of them will be shown at the notice board of our organization in Pardubice city-centre.
The post-activity evaluation meeting (October 2009)
Two Czech participants/leaders of the project will go to Sweden to discuss and evaluate project’s
results and middle-term impact and to plan follow-up activities between participants and the partner
organizations. (A possible next exchange in 2010 – Swedes coming to the Czech Republic;
possibly a job shadowing, study visit or seminar for youth leaders from participating organizations).
Youth in Action Programme – Sub-Action 1.1 - Youth Exchanges
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Inclusion of young people with fewer opportunities:
Does your project involve young people with fewer opportunities (facing situations that make their inclusion in society more
difficult, see main situations/obstacles identified herebelow) and/or special needs (mobility problems, health care, etc.)? If so,
please describe and motivate.
Some participants of our project are coming from small towns in poorer regions of the Czech
Republic (Vysočina, Žamberecko). Because of living out of social, cultural, political centres (big
cities) with worse transport services, these young people have fewer opportunities to participate in
different activities.
Number of young people with fewer opportunities directly involved in the project (out of the total number of participants
indicated in Part IV, Table A of this form): 5
Please tick the situation(s) they face:
Social obstacles
Economic obstacles
Disability
Educational difficulties
Cultural differences
Health problems
Geographical obstacles
Other – please specify:
Youth in Action Programme – Sub-Action 1.1 - Youth Exchanges
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Part VI. Budget
All items in euros
For further information please consult the Programme Guide for the overview of funding rules and the lump sums/scales of unit
costs set out by your National Agency. Please note that the Executive Agency and the National Agencies may modify the
amounts indicated in the grant request according to the funding rules of the Programme Guide.
A. Grant requested from the Youth in Action programme
Please fill in only one section (A.1, A.2 or A.3) below.
A.1 Sending Organisation
Amount requested
from the
Youth in Action
Programme
Amount granted
(to be filled in by the
Executive Agency or
the National Agency)
(Bilateral and trilateral projects submitted at national level)
Travel costs (70% of actual costs)
5285 €
Advance Planning Visit – travel costs (100% of actual costs)
930 €
Advance Planning Visit – other costs (scale of unit costs)
192 €
Preparation costs (lump sum)
336 €
Exceptional costs (100% of actual costs) – if applicable
-
Costs for additionnal dissemination and exploitation of results
(100% of actual costs – up to € 500 x number of promoters –
maximum € 2.500)
500 €
7243 €
Total grant for the Sending Organisation
A.2 Host Organisation
(Bilateral and trilateral projects submitted at national level)
Travel costs (70% of actual costs)
Preparation costs (lump sum)
Activity costs (lump sum + scale of unit costs)
Exceptional costs (100% of actual costs) – if applicable
Costs for additionnal dissemination and exploitation of results
(100% of actual costs – up to € 500 x number of promoters –
maximum € 2.500)
Total grant for the Host Organisation
A.3 Coordinating Organisation
Only for: 1) Multilateral and itinerant projects submitted at national level
2) All projects submitted at European level
Travel costs (70% of actual costs)
Advance Planning Visit – travel costs (100% of actual costs)
Advance Planning Visit – other costs (scale of unit costs)
Preparation costs (scale of unit costs)
Activity costs (lump sum + scale of unit costs)
Exceptional costs (100% of actual costs) – if applicable
Costs for additionnal dissemination and exploitation of results
(100% of actual costs – up to € 500 x number of promoters –
maximum € 2.500)
Total grant for the Coordinating Organisation
Youth in Action Programme – Sub-Action 1.1 - Youth Exchanges
Page 19
Part VI. Budget (cont.)
All items in euros
B. Co-financing
Please consider that the percentage of travel costs not covered by the EU grant should be indicated below.
Amount
Own resources (co-financing of travel costs, printing of posters for project’s result
dissemination, other costs)
2310 €
Other contributions to this project (please specify each source):
-
2310 €
Total of co-financing
Yes
Did your organisation/group apply for/receive an EU operating grant for the current year?
No
If so, please specify the contract number:
C. Detailed calculation of grant request
If more space is needed, please add rows.
Travel costs (young people and group leaders)
Travel costs from home to the venue of the project and return. For itinerant projects: travel costs from home to the place where
the Activity starts and travel costs from the place where the Activity ends to home. Please note: only cheapest means of
transport/fares are subject to reimbursement.
Promoter
Number of
persons
From
To
Means
of transport
Total costs
(100%)
Grant
requested
(70%)
OK Lokomotiva
Pardubice, o.s.
16
Pardubice,
Jihlava,
Žamberk, Nové
Město n. M.,
Doudleby
Praha-hl.n. and
back
Train
206 €
144 €
OK Lokomotiva
Pardubice, o.s.
16
Praha-hl.n.
Praha-Ruzyně
and back
Airport
Express
59 €
41 €
OK Lokomotiva
Pardubice, o.s.
16
Praha
StockholmArlanda and
back
Plane
5925 €
4148 €
OK Lokomotiva
Pardubice, o.s.
16
StockholmArlanda
Falun and back
Train
1360 €
952 €
7550 €
5285 €
TOTAL
Advance Planning Visit – travel costs (if applicable)
Please note: only cheapest means of transport/fares are subject to reimbursement.
Promoter
Number of
persons
From
To
Means
of transport
Costs
OK Lokomotiva
Pardubice, o.s.
2
Pardubice and
Doudleby
Praha-hl.n. and
back
Train
22 €
OK Lokomotiva
Pardubice, o.s.
2
Praha-hl.n.
Praha-Ruzyně
and back
Airport
Express
7€
OK Lokomotiva
Pardubice, o.s.
2
Praha
StockholmArlanda and back
Plane
741 €
OK Lokomotiva
Pardubice, o.s.
2
StockholmArlanda
Falun and back
Train
160 €
Subtotal
930 €
Youth in Action Programme – Sub-Action 1.1 - Youth Exchanges
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Advance Planning Visit – other costs (if applicable)
Promoter
OK Lokomotiva
Pardubice, o.s.
Number of
persons
Venue
Number
of nights
Unit cost
per night
2
Falun, Sweden
2
48 €
192 €
Subtotal
192 €
TOTAL ADVANCE PLANNING VISIT
1122 €
Total
-
Preparation costs – scale of unit calculation (only for Multilateral Youth Exchanges)
Number of promoters
Unit cost per promoter
Total
-
-
Preparation costs – lump sum calculation (only for Bi-trilateral Youth Exchanges)
336 €
Total
Activity costs – lump sum calculation
-
Subtotal
Activity costs – scale of unit calculation (young people and group leaders)
Country
Number of
participants
Number of nights
Unit cost
per night
Total
Subtotal
-
TOTAL ACTIVITY COSTS
Exceptional costs (if applicable)
Please consult the overview of funding rules for exceptional costs as defined in the Programme Guide.
Specification
Costs
-
TOTAL
Additional costs for dissemination and exploitation of results (if applicable)
Please consult the overview of funding rules for additional dissemination activity costs as defined in the Programme Guide.
Specification
Costs
500 €
Evaluation meeting in Sweden after the activity (a part of travelling costs for two
participants from the Czech Republic)
-
500 €
TOTAL
Youth in Action Programme – Sub-Action 1.1 - Youth Exchanges
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Part VII. Bank details
Please fill in the details needed for the payment to reach the account of the applicant.
A. Account details
Account holder
OK Lokomotiva Pardubice
Address
Palackého 2547
Postcode
530 02
City
Region
Pardubický kraj
Country Czech Republic
Family name (Ms/Mr)
Mr. Klimpl
First
name
Petr
Email
[email protected]
Telephone
+4204665410154
Telefax
+4204665410154
City
Pardubice
Pardubice
Contact
B. Bank details
Bank name
Raiffeisenbank a.s.
Branch address
Postcode
Region
Account number
IBAN11
Pardubický kraj
Country Czech Republic
1069724001/5500
CZ20550000000010697224001
Remarks
11
If the IBAN Code (International Bank Account Number) is applied in the country where your bank is situated.
Youth in Action Programme – Sub-Action 1.1 - Youth Exchanges
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Part VIII. Signature of the legal representative
The applicant undertakes to inform the Executive Agency or the National Agency of all changes affecting the
activities as described in this form.
The applicant allows the European Commission, the Education, Audiovisual and Culture Executive Agency and
the National Agencies to make available and use all data provided in this application form for the purposes of
managing and evaluating the Youth in Action Programme. All personal data collected for the purpose of this
project shall be processed in accordance with Regulation (EC) N° 45/2001 of the European Parliament and of
the Council on the protection of individuals with regard to the processing of personal data by the Community
institutions and bodies.
Data subjects may, on written request, gain access to their personal data. They should address any questions
regarding the processing of their personal data to the Education, Audiovisual and Culture Executive Agency or
the relevant National Agency. Data subjects may lodge a complaint against the processing of their personal data
with the European Data Protection Supervisor at any time.
Applicant
Name:
OK Lokomotiva Pardubice, občanské sdružení
Legal representative
Name in capital letters:
PETR KLIMPL
Place:
Pardubice
Date:
29. 3. 2009
Youth in Action Programme – Sub-Action 1.1 - Youth Exchanges
Signature:
Page 23
Part IX. Declaration on honour
To be completed by the person authorised to enter into legally binding commitments on behalf of the applicant.
I, the undersigned, certify that all information contained in this application, including project description, is
correct to the best of my knowledge and am aware of the content of the annexes to the application form.
I confirm that my organisation/group has the financial and operational capacity to complete the proposed
project.
I confirm that my organisation/group has taken the appropriate measures to ensure the protection and
safety of participants involved in the project.
I take note that under the provisions of the Financial Regulation applicable to the general budget of the
European Communities12, grants may not be awarded to applicants who are in any of the following
situations:
(a) if they are bankrupt or being wound up, are having their affairs administered by the courts, have
entered into an arrangement with creditors, have suspended business activities, are the subject of
proceedings concerning those matters, or are in any analogous situation arising from a similar procedure
provided for in national legislation or regulations;
(b) if they have been convicted of an offence concerning their professional conduct by a judgment which
has the force of res judicata;
(c) if they have been guilty of grave professional misconduct proven by any means which the contracting
authority can justify;
(d) if they have not fulfilled obligations relating to the payment of social security contributions or the
payment of taxes in accordance with the legal provisions of the country in which they are established or
with those of the country of the contracting authority or those of the country where the contract is to be
performed;
(e) if they have been the subject of a judgment which has the force of res judicata for fraud, corruption,
involvement in a criminal organisation or any other illegal activity detrimental to the Communities' financial
interests;
(f) if following another procurement procedure or grant award procedure financed by the Community
budget, they have been declared to be in serious breach of contract for failure to comply with their
contractual obligations;
(g) if, on the date of the grant award procedure, they are subject to a conflict of interest;
(h) if, on the date of the grant award procedure, they are guilty of misrepresentation in supplying the
information required by the contracting authority as a condition of participation in the grant award
procedure or fail to supply this information.
I confirm that neither I nor the organisation/group for which I am acting as legal representative are in any of
the situations described above, and am aware that the penalties set out in the Financial Regulation may be
applied in the case of a false declaration.
In the event that my grant application is successful, I authorise the Commission/the Agency to publish on its
internet site or in any other appropriate medium:

The name and address of the beneficiary of the grant;

The subject of the grant;

The amount awarded and the rate of funding of the costs of the approved work programme.
Place:
Pardubice
Signature:
29/03/2009
Stamp of the applicant (if available):
Name in capital letters:
PETR KLIMPL
Position/function:
Chairman
12
Date (day/month/year):
Council Regulation N° 1605/2002 (OJ L248 of 16/09/2002), Commission Regulations N° 2342/2002 (OJ L357 of 31/12/2002)
and N° 1248/2006 (OJ L227 of 17/08/2006). These can be consulted in the Official Journal online at http://eurlex.europa.eu/JOIndex.do.
Youth in Action Programme – Sub-Action 1.1 - Youth Exchanges
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Check list
Before returning this application form to the Executive Agency or to the National Agency, please check the following:
 The application form must be accompanied by:
an official letter from the applicant and all the other documents referred to in the application form.
 The application must include the following documents:
the present application form, duly completed and signed in original by the person authorised to
enter into legally binding commitments on behalf of the applicant (signatures required in Parts VIII
and IX of this form), together with the Preliminary agreements with all partner promoters, duly
completed and signed in original. Please note that Preliminary agreements can be provided in the
form of fax (when submitting the application) on the condition that they are complemented by
orginals that must be received by the NA before the Evaluation Committee takes place.
 Additional mandatory documents for grant requests exceeding € 25 000:
In accordance with the provisions of the Financial Regulation applicable to the general budget of the
European Communities, all applicant promoters – with the exception of public bodies and informal groups
of young people – to EU funding exceeding € 25 000 must submit, together with their application form, the
following financial documents:
the profit and loss accounts of the applicant,
and
the balance sheet for the last financial year for which the accounts have been closed.
The objective is to permit an assessment of the financial capacity of the applicant promoters.
Please note there is no specific form to submit the information outlined above.
 Additional mandatory documents for projects submitted at National level only13:
only for non governmental organisations: an extract from the official gazette/trade register, and
certificate of liability to VAT (if, as in certain countries, the trade register number and VAT number
are identical, only one of these documents is required);
only for public bodies: a legal resolution or decision or other official document established in
respect of the public body;
only for informal groups of young people: a copy of the group representative's identity card or
passport.
13
These documents do not have to be provided if the applicant has already submitted them in occasion of a previous
application under the Youth in Action Programme; on the condition that no changes have occurred in the
meantime.
 Additional mandatory documents for projects submitted at European level only:
the legal entities sheet duly signed by the person authorised to enter into legally binding
commitments on behalf of the applicant (individual/private companies/public entities). Please note
that complementary justification documents are required according to the applicant’s status, as
specified in each type of form. (This sheet can be downloaded from the European Commission’s
website: http://ec.europa.eu/budget/execution/legal_entities_en.htm#en_es_fr)
the financial identification sheet duly signed by the person authorised to enter into legally
binding commitments on behalf of the applicant and certified by the bank (original signatures
required). Please fill in the form relating to the country in which the bank is located, even if the
applicant organisation is officially registered in another country. (This sheet can be downloaded
from the European Commission’s website: http://ec.europa.eu/youth/program/financial_
identification_en.html)
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