Internship / Fellowship Application Form

Applicant Details

InternshipFellowship

Name

Address

Gender

Occupation

Nationality

Date of Birth

Place of Birth

Contact Details

Telephone Number

Fax Number

Mobile Number

Email Address

Languages

English

Read/UndertandWriteSpoken

French

Read/UndertandWriteSpoken

Other

Work experience

From:
To:
Type of Business:
Employer:
Brief description of your duties:

From:
To:
Type of Business:
Employer:
Brief description of your duties:

From:
To:
Type of Business:
Employer:
Brief description of your duties:

Educational Qualifications

1.

Institution

Date

Qualifications Obtained

2.

Institution

Date

Qualifications Obtained

3.

Institution

Date

Qualifications Obtained

About the internship

Please indicate your area(s) of interest:

LegalStudy & ResearchInformation & DocumentationFundraisingAdministration & Finance Other

Proposed duration and timing of the Internship

From

To

Source of Funding:

How did you hear about IHRDA

Why do you want to intern with IHRDA

Any other relevant Activity or information to the internship for which you are applying

Emergency contact information

In case of emergency, notify:

Name

Gender

Relation

Occupation

Address

Fax

E-mail

Telephone

Referees

Name and addresses of two referees:

Name

Address

Telephone

Mobile

Email

Skype

Name

Address

Telephone

Mobile

Email

Skype

I certify that the statements made by me in answer to the foregoing questions are true, complete, and correct to the best of my knowledge and belief. I understand that any misinterpretation or material omission made on this application form, or other document requested by the Organization renders an intern with the IHRDA liable for termination or dismissal.

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