Application Form for DPF (English)1

DISHA PARIVARTAN FELLOWSHIP
APPLICATION FORM

Deadline: December 31, 2019

To Apply Offline: Download PDF Application form here!

Basic Information first..

* Indicates required field

Name of the Applicant *

First

Last

Email Address *

GENDER *

Male Female Other

Mobile Number *

Date of Birth (DD/MM/YYYY) *

Upload your latest Photograph *

Max file size: 20MB

Name of the Initiative *

When was the initiative launched? *

Your position in the initiative? *

Present Address *

How did you come to know about us (In case of 'a friend', kindly mention the name)? *

About your initiative..
[Do not forget to save your responses offline]

Kindly share the vision of your initiative. *

Who are the people whom you wish to serve through your initiative? *

Kindly share about the work you have done so far. *

Provide web-links related to the initative (Website/ Blog/ Facebook Page/ Videos/ Brochure etc) *

Upload files related to your work done so far in a compressed file format. *

Max file size: 20MB

Kindly share financial details related to the initiative. *

Upload files related to your financial details in a compressed file format. *

Max file size: 20MB

How have you managed your finances so far? *

How do you plan to self-sustain your initiative in long run? *

About your professional journey so far..

PREVIOUS WORK EXPERIENCE
Start with the most recent first:

Dates (From-To) [1] *

Dates (From-To) [2] *

Dates (From-To) [3] *

Name of the Organization and Area of work [1] *

Name of the Organization and Area of work [2] *

Name of the Organization and Area of work [3] *

Position held [1] *

Position held [2] *

Position held [3] *

ACADEMIC INFORMATION

Qualification Title [1] *

Qualification Title [2] *

Qualification Title [3] *

Qualification obtained from [1] *

Qualification obtained from [2] *

Qualification obtained from [3] *

Dates (From-To) [1] *

Dates (From-To) [2] *

Dates (From-To) [3] *

To understand you better..
[Do not forget to save your responses offline]

What inspires you to work on your social initiative? *

What are your major challenges on the path that you have chosen for yourself? *

What has been your personal journey so far, including your family background, achievements, failures etc. *

How can this fellowship help you on your journey? *

DECLARATION
I hereby declare that all the information provided by me in this application form is true to the best of my knowledge and belief. I have gone through all the details of this fellowship application, particularly related to 'who is eligible to apply as a Disha Parivartan Fellow' and 'who is not eligible to apply as a Disha Parivartan Fellow', and have found myself to be eligible of applying for this fellowship.

I further declare that if I am selected for this fellowship after due selection process, I shall honestly abide by the mandatory pre-requisites of the same and shall adhere to the following: 1) being involved in the initiative full-time during the fellowship period 2) working for the benefit of economically or socially disadvantaged section of the society through a non-profit initiative 3) promoting a healthy value system 4) having registered an organization if advised to do so. I completely understand that if I violate any one of these conditions, the fellowship management team shall hold the right to discontinue my candidature for the fellowship after giving one month notice period.

Submit

DISHA PARIVARTAN FELLOWSHIPAPPLICATION FORM

Basic Information first..

About your initiative..[Do not forget to save your responses offline]

About your professional journey so far..

To understand you better..[Do not forget to save your responses offline]

DISHA PARIVARTAN FELLOWSHIP
APPLICATION FORM

About your initiative..
[Do not forget to save your responses offline]

To understand you better..
[Do not forget to save your responses offline]