Application for Queerala Diversity Scholarship-2019
(Kindly answer all questions. The information collected via this form shall be used only for the internal documentation and assessment purpose and not be shared with any other entity, in any manner)
Email address *
Name *
Age *
Contact Number *
Course of Study *
Name of College/ University (Name the institution you are currently enrolled in ) *
Can we make public announcements with your name and educational affiliation on our social media handles and media houses? (In case you are awarded the scholarship) *
Have you been part of any LGBTIQA+ advocacy initiatives or campaigns, in Kerala? If yes, Please give details. *
Say us about yourself with details of your interests, hobbies aspirations etc. *
Do you see yourself being part of the LGBTIQA+ initiatives in Kerala in near future? If yes, How? If No, Why? *
Thanks for your very valuable time!
Team Queerala
A copy of your responses will be emailed to the address you provided.
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