DNSI 2

MINISTRY OF YOUTH, SPORT AND CULTURE

DEPARTMENT OF NATIONAL SERVICE AND INTERNSHIP

REQUEST FORM

(NATIONAL SERVICE-TIRELO SETSHABA INTERNSHIP, GRADUATE VOLUNTEER SCHEME,)

NAME OF ORGANISATION ………………………………………………………………………………………

SECTOR: Public Parastatal Private NGO/CBO

COMPANY REGISTRATION NO: (for private companies only) …………………………………………

COMPANY VAT NO: Offi(for private companies

Offi only)…………………………………………………………
Offi Offi
ce ce ce ce
PHYSICAL ADDRESS: sta
……………………………………………………………………………………………………….
sta sta sta
mp mp mp mp
TELEPHONE NO: …………………………………… DATE OF REQUEST………………………

No. of Qualifications Duty Station Department/ Brief Job Description

positions required Division
required

NB: Please attach Company Profile if requesting for the first time.

This request is made by ……………………………………………………………… In his/her capacity as ……………………

Signature: …………………………………

Official stamp (requesting

organisation)

Department of National Service and Internship – DNSI –MYSC BW

 DNSI 2

DNSI Office Decision: Approved Rejected

Offi Offi
Officer’s Name…………………………………………………………….
ce ce
Officer’s Signature……………………………………………………….
sta sta Official stamp (DNSI)
mp mp
Head of Placement name: ……………………………………………
Head of Placement signature: ……………………………………..

Department of National Service and Internship – DNSI –MYSC BW