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SWACHH BHARAT MISSION GRAMEEN INTERNSHIP-2023
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Name of Individual/Team Members
Copy
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Photograph (Passport Size)/Team Photograph
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Permanent Address/Team Leader Permanent Address
District:-
Block:-
Panchayat:-
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Present Address/ Team Leader Address
District:-
Block:-
Panchayat:-
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Email/ Team leader email
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Phone number/ Team Leader Phone number
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Preference of Location For Internship
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Educational Qualifications (Graduate/Post Graduate/Research Scholar)
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Any prior experience working in the field of Sanitation in Rural Areas?
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Reason to join the internship programme (100 words)
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References ( Institute with Phone No and Email Id)
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Signed Document of Approval From Parent Institute in which you are currently studying (College/University)
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Upload educational qualifications ( Pdf form less than 10 MB)
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