Ek Soch Fellowship on Social Entrepreneurship - 2017-18 Application
Please fill out in CAPITAL LETTERS only. (For any assistance call at 9741878654)
Part I. Basic Information
Full Name *
Your answer
Date of Birth (Day/ Month/ Year) *
Your answer
Sex *
Email ID *
Your answer
Mobile Number *
Your answer
Home Phone Number *
Your answer
Postal Address *
Your answer
Citizenship *
Your answer
Part II. Background Information
Educational Qualification *
Educational Information from 10th standard onward *
Include name & address of institution, degree and score. (Please press enter after each entry)
Your answer
Family Member Information *
Include name, occupation and qualification of your father, mother, siblings and spouse
Your answer
Language Proficiency : English *
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Speaking
Reading
Writing
Comprehension
Language Proficiency : Hindi *
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Good
Great
Speaking
Reading
Writing
Comprehension
Do you speak any other Languages?
If so please label them #1 and #2 and fill in information about your proficiency below.
Your answer
Language Proficiency : Other Language #1
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Good
Great
Speaking
Reading
Writing
Comprehension
Language Proficiency : Other Language #2
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Good
Great
Speaking
Reading
Writing
Comprehension
Part III. Experience
Please mark your areas of expertise, if "Other" please specify (can be multiple areas) *
Required
Please tell us about your professional experience, including volunteer work *
Include the organization, location, position, dates (From month/year- To month/year) and responsibilities. Please include two experiences.
Your answer
Part IV. References
Name of Reference *
Your answer
Designation of Reference *
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Email ID of Reference *
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Contact Number of Reference *
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Part V. Miscellaneous
All applicants are required to submit an application fee of Rs.500/- for their applications to be considered. This application fee should be submitted in the form of a cheque or by demand draft (DD) in the name of “DESHPANDE EDUCATIONAL TRUST” and is payable at Hubballi. Same can be paid in cash at the time of interview.
Application fee (Mode of payment) *
DD Number (If Applicable)
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Bank Name and Place (for DD)
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Date of DD
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Any additional detail
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