SRHR-Defenders Application
Join our revolutionary campaign 'Health Over Stigma' where women around New Delhi are standing up to the shame and stigma that we face almost everyday in relation to our bodies and our sexual health. We are no longer going to let stigma stand over the importance of ourselves and our health!

Do you want to become a defender of women's rights and stand up in this fight to demand non-judgemental services from gynaecologists in Delhi? Do you want to move from just talking about change to playing a pivotal role in this strong and powerful movement? Not sure if you meet the criteria to be a SRHR Defender, read more information here:

Fill in the application form below for a chance at getting selected as the second cohort of SRHR Defenders. Defenders are passionate leaders who will be working on the ground to get doctors to commit to our '10 Commandments' and women to join the campaign through 'The Vagina Dialogues'.

20 Defenders will be selected to join Health Over Stigma and this is a 4 month long engagement. The Mandatory on-boarding for the Defenders will take place on 24th of June. Applications close June 19th!

This campaign is spearheaded by Haiyya a Non-Profit Campaigning Organization. Read about us @ If you have any additional questions please feel free to email us at

Email address *
Name *
Your answer
Phone Number *
Your answer
Are you unmarried? *
Have you been associated with Haiyya or the campaign in any capacity? (If yes please explain) *
Your answer
Please provide details about your college (program of study, college name and year) or current employment *
Your answer
Can you commit to 8-10 hours a week? *
Will you be based in New Delhi during (June - September) *
How did you hear about this application? *
Why do you want to defend women's right to access of sexual health services? Please share a story or experience that explains your motivation *
150-300 words
Your answer
What are the skills or resources that you bring to the campaign? Please be specific e.g. Photography, dance group network of women *
Your answer
Are you available for a 5-6 hour training on June 24th *
Tell us a fun fact about yourself *
Your answer
A copy of your responses will be emailed to the address you provided.
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms