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APPLICATION FOR PAID INTERNSHIP AT MOHAN Foundation

Photograph

PERSONAL INFORMATION

DATE OF APPLICATION:

Name:
Last

First

Middle

Address:
Street

City/State

Contact Information:

Pincode/ Zip Code

Email:
Cell Number

Date of Birth / Age:
POSITION: INTERN

Sex: M ( ) F ( )
Available Start Date:

TYPE OF INTERNSHIP
WORK ONLY FOR MOHAN FOUNDATION PROJECTS
WORK TO COMPLETE PROJECTS RELATED TO COLLEGE
(Note – Projects where you work only for MOHAN FOUNDATION are eligible for monthly stipends of Rs.5000 or US $100 )

Area of Interest for MOHAN FOUNDATION PROJECTS

Communications

Marketing

Database Management

Resource Mobilization

Research

Liaison with Government

Maximum of two areas can be selected

DURATION: ____ EMERGENCY Contact Person Name: Phone Number: Land Line Mobile ____ Address 1st line of address ____ 2nd line of address ____ City State Country ____ ____ EDUCATION Name and Location Degree Majors & Subjects of Study High School College or University Specialized Training If any PREVIOUS EXPERIENCE Please list beginning from most recent Dates Employed Company Name Location Role/Title Dates Employed Company Name Location Role/Title AWARDS / MEDALS / DISTINCTION .

REFEREES Name Position Email Contact No Signature (Type your Name for Signature) Please Note: A stipend will be provided from the second month after completing one month and having a satisfactory report of performance. DO NOT WRITE BELOW THIS LINE ____________________________________________ Accepted: YES _________/ NO_________ By ___________________________ Begin Internship on: (date) _______________________ . REFEREES 2.PUBLICATIONS IF ANY – ANY OTHER RELEVANT INFORMATION YOU MAY WISH TO SHARE 1.