InternshipFellowship
Name
Address
Gender
Occupation
Nationality
Date of Birth
Place of Birth
Telephone Number
Fax Number
Mobile Number
Email Address
English
Read/UndertandWriteSpoken
French
Other
From: To: Type of Business: Employer: Brief description of your duties:
Institution
Date
Qualifications Obtained
Please indicate your area(s) of interest:
LegalStudy & ResearchInformation & DocumentationFundraisingAdministration & Finance Other
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
In case of emergency, notify:
Relation
Fax
E-mail
Telephone
Name and addresses of two referees:
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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