Mental Health Exchange Programme - Netherlands, 1st wave

Fill form with idloom.passport

No account yet? Please register to this event and your account will be created automatically.

Contact information

First name *

Last name *

Age *

Nationality *

Country of Residence *

Please note that you must be resident in one of the 27 EU Member States, Iceland or Norway in order to apply. A total of 150 participants will be selected, with quotas assigned to sending countries based on their population size and active engagement in the mental health sector.

Email *

Please confirm by entering your Email address twice.

Confirm the previous field *

Mobile Phone *

My level of English is equal or major of B/intermediate *

Exchange visits will be performed in English. This is an intermediate-level qualification for those who master the basics of English and have practical language skills for everyday use. Please assess your English proficiency using the Europass Self-Assessment Grid based on the CEFR.
Link to the Europass Self-Assessment Tool: https://europass.europa.eu/en/common-european-framework-reference-language-skills

Affiliation with Exchange Hosting Organisations

Do you work for / cooperate with one of the other organisations that hosts our Exchange Programme? *

Please indicate if you are affiliated with any exchange hosting organisation from another hub to be considered for priority participation in this visit.

Inclusion

Gender Identity *

Professional Information

Please select your professional profile: *

Years of Experience *

Institution/Organisation *

Years within the Institution/Organisation *

Position within the Institution/Organization *

Please describe your responsibilities and tasks in your daily job in English

Motivation/Attitude

Applicants should provide clear and well-structured motivation letters, demonstrating an understanding of the program's objectives and a strong commitment to their professional growth.

Please share a specific personal experience or realisation that inspired you to apply for this exchange programme, which focuses on learning about another country's mental health practices and community-based care system. How has this experience shaped your view on the significance of community-based mental health initiatives? *

Please write in English not more than 250 words

In the future, how do you plan to integrate the knowledge gained from studying another country's practices and systems into your career goals? What impact do you aim to achieve in your community or field as a result of this exchange experience? *

Please write in English not more than 250 words

Areas of Interest and Specific Requirements

Are you particularly interested in one of the areas of the programme? Please indicate (Please note that this does not guarantee any specific arrangements from the organisers.):

Travel and logistics

How do you prefer to travel to the destination? *

Please be aware that flights are booked directly by us. All other modes of transport will be booked by you and reimbursed after completion of the Exchange Programme.

Please choose your starting airport (in your home country) *

What are your travelling preferences for the outbound flight? *

Checkin is at 3pm. Please note that we aim to book a flight for Sunday, as the programme starts on Monday morning. If you like to arrive on a different day, please indicate this in "other".

What are your travelling preferences for the return flight? *

The check-out time is 12pm. The return flight will be booked for Saturday. If you like to leave on Friday or Sunday (or later), please indicate this in "other". Remember that check-out time is 12pm. If you like to stay longer at your own expense and risk, we offer you to book a later flight. Please be aware that all expenses related to personal travel or use must be paid by you.

I agree that my data (name, surname, mobile, ID) will be shared with the travel agency for flight booking. *

If you don't agree, please choose a different mode of transport.

Reimbursement

I have read and understood the terms and conditions for reimbusement of travel and meal expenses. *

Special Needs & Arrangements

Do you have any medical conditions or pathologies that we should be aware of? If yes, please provide details.

Please also provide details on arrangements that should be made by our side.

Do you have any dietary restrictions or special requirements? *

Please specify your allergies: *

Do you need any special arrangements due to disabilities or special needs? Please specify.

Will you require daycare services for your child(ren) during the Exchange Visit?

Please provide the name of your spouse *

Emergency Contact

Please provide the name and phone number of an emergency contact. Please make sure that this person speaks English.

Full Name *

Email Address *

Confirm the previous field *

Phone Number *

Relationship *

Yes, my contact is able to communicate in English. *

If not, please provide a different contact, otherwise we are not able to communicate with your contact.

European Health Insurance Card (EHIC)

Do you have your EHIC? If you have another insurance, indicate this in the field "other" *

Please check if you already have a European Health Insurance Card (EHIC). You can find this information on the back of your health insurance card. If you do not have one, please request it from your health insurance provider. All EU participants, as well as participants from Norway and Iceland, are covered through their EHIC for any medical needs. If you do not have an EHIC, please request it from your country of residence. If you are not covered, inform your event manager, and individual arrangements will be made.

Official Invitation Letter Requirement

Do you need an official invitation letter for your organization to authorize the mission? *

Data sharing consent

I agree to share my contact details with the members of my group

I have read and understood the Consent for Data Protection Notice for the Exchange Visits. *

Cancellation Policy

Thank you for confirming your participation in the Mental Health Exchange Programme. We kindly ask for your agreement to these terms to ensure the smooth organisation of the programme and to maximise participation opportunities. As this initiative is funded with a limited budget, non-refundable costs such as flights and accommodation must be carefully managed. By agreeing to this policy, you help us minimise financial losses from late cancellations, allowing us to allocate resources effectively and offer this valuable exchange experience to as many participants as possible. By completing this second registration form, you acknowledge and agree to the following terms and conditions:

I agree to the terms regarding non-refundable costs, cancellations, and providing accurate personal information. Please read the policy below carefully. *

⚠️ Non-Refundable Costs

Once you confirm your participation, we will:

Purchase non-refundable flight tickets.
Reserve your hotel room for the full programme duration (14 nights).

These costs cannot be recovered if you cancel after confirming.

⚠️ Your Responsibility

You must provide accurate personal information, including your gender and full name as it appears on your passport or ID.
If incorrect information causes issues (e.g., ticket cancellations or rebooking), you will pay all related fees, such as:
- Cancellation charges
- Rebooking fees
- Differences in ticket prices

‼️ Cancellation Policy

If you cancel after confirming your participation, you agree to:
- Reimburse us for any non-refundable costs (flights, accommodation, etc.).
No refunds will be given unless exceptional circumstances apply.

I confirm my participation in the Mental Health Exchange Programme *

‼️ Commitment to Participate

By confirming, you commit to attending the programme and understand the financial consequences of late cancellations.
Check your availability carefully before submitting this form.

Registration fees

Registration to this event