“The Four Elements of Nature and their Effect on Us” Comenius Meeting in Porto- 19-25 January 2014 COMENIUS STUDENT INFORMATION FORM To be completed by all students and forwarded to maria.g.cruz@gmail.com PLEASE PRINT IN CAPITALS Visit Porto – January 2014 Name of Student First name Surname Gender Male Female Date of Birth Age Country Parents/Guardians ´names Home Address Parent ´s Email Student´s Email EMERGENCY CONTACT NUMBERS Home Mobile – Student mobile Medical information Asthma/allergies Date of last tetanus injection if known Food ( indicate food not eaten for religious, ethical or health reasons) Languages spoken Interests Any other information which may be useful in an emergency for the host family/teachers