The Republic of Lebanon
Ministry of Foreign Affairs and Emigrants
The General Directorate of Emigrants

Participation Form to the Tenth Lebanese Emigrant Youth Camp
(From July 16 to July 24, 2010)

The Ministry of Foreign Affairs and Emigrants - General Directorate of Emigrants - invites all Lebanese young
emigrants (aged between 17 and 25) wishing to participate in this Event to fill the following form and send it
directly to the General Directorate of Emigrants or the through diplomatic missions abroad. The stay in Lebanon
will be on the Ministry's expense. The participants will pay their trip to Lebanon. The program includes cultural seminars,
environmental activities and excursions throughout the archeological and touristic sites all over Lebanon.

NB:
- Please write in capital letters or type
- Check the appropriate box with "X"
- Enclose with the application a photocopy of the passport and two passport photographs
- Quick declaration about your arrival date to Lebanon and the flight number

Personal Information

----First Name:

.Father's Name:

--Family Name:

------------Sex: Male Female
---Date of Birth: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 1 2 3 4 5 6 7 8 9 10 11 12 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008
-------------- ---Day ---- Month ---Year
--------Country:

------------City:

--------Address:

------Telephone:

-------------Fax:

----------E-mail:

-------Education Secondary Technical
-----------Level: University Specialization

-----Occupation:

Languages
-------Arabic: Excellent Good Fair
-------French: Excellent Good Fair
-------English: Excellent Good Fair
------Spanish: Excellent Good Fair
---Portuguese: Excellent Good Fair

Hobbies
Playing music: (Specify)

-----Dancing:

-------Sports: (Specify)

------Singing:

--Handicrafts:

------Theater:

--------Other: (Specify)

Could you bring something that reflects the folklore of

the country you live in? No Yes (Specify)

Participation in other activities:

No Yes (Specify)

Health Condition

Blood Type:

Do you have any illness? No Yes if yes Specify:

Are you undergoing any permanent treatment? No Yes if yes Specify:

Are you allergic to any medicine? No Yes if yes Specify:

Did you have any surgery? No Yes if yes Specify:

Did you participate before? No Yes if yes Specify year:

I hope that you will accept my application on my own responsibility, and i commit myself to abide by the rules and participate in all the activities. i received the participation form from the:

Embassy Lebanese Emigrant Club Internet Directly Other:

--------------------------------

For those who are under 17 Years of age, the authorization of the guardian

I authorize to participate in the

Tenth Lebanese Emigrant Youth Camp on my own responsibility.

Name: Date: