YOUth LEADers

Please complete the following form and submit by the deadline - 19th June 2016.

Age

Must be a number greater than 15

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Gender

Male
Female
Other

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Email id

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Full Name

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Phone number

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What is your current occupation? (E.g: Student/ Professional/ Freelance/Recent Graduate, etc)

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Undergraduate College

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Area of Residence in Bangalore

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Do you have your own means of transport?

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Undergraduate Degree / Course

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Why do you want to be a part of this programme?

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If you are not free for the entire duration of the programme, please indicate the duration you will be available:

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Any particular skills you have that you feel will add value to the programme? (If you have any experience working with design software, making presentations, conducting field work including interviews, data analysis, etc, mention below):

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Do you have any previous work experience (including other internships)? If yes, briefly describe it here:

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Do you have any other queries or comments?

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