Application for Queerala Diversity Scholarship2018
(Kindly fill all columns to ease our documentation process. 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, without prior consent)
Email address *
Name *
Your answer
Age *
Your answer
Contact Number *
Your answer
Course of Study(or Latest done course) *
Your answer
Educational Institution which you belong to(passed out from) *
Your answer
Are you part of the student wing of any political entity or do you volunteer for any social cause? *
If Yes; Kindly mention. *
Your answer
Do you think campuses in Kerala, in general, are LGBTIQ friendly? *
If No, what suggestion you have to envision sexual minorities friendly campuses, in our state? *
Your answer
Do you think, any of you interests or talents can be deployed towards the LGBTIQ movement in Kerala? *
If Yes, in what capacity and forms? (Give examples, like contributing articles, conducting surveys etc) *
Your answer
How do you identify yourself as in the LGBTIQ+ spectrum? *
Your answer
How did you come to know about this Scholarship *
Why would you Like to Apply for Queerala' Diversity Scholarship? *
Your answer
Would You be comfortable to share you name and photograph, in our Website and Facebook page, if You get selected for the Scholarship? *
Do you now any LGBTIQ student in your campus? *
Do you think campuses in Kerala should address the Human Rights concerns of the sexual minorities in a better manner? *
Do you think your campus can form an LGBTIQ Support Group? *
Has there been any LGBTIQ related event/program at your institution before? *
If Yes, Kindly mention *
Your answer
On a scale of 1-10, How aware are your regarding the Diversity in Sexual Orientation and Gender Identity? *
Your answer
What can you, as a Human Rights enthusiast, do if any student in your campus Comes Out as Gay/Lesbian/Bisexual/Transgender? *
Your answer
In your view, what major issues are faced by LGBTIQ youth in our state? *
Your answer
Tell us, in short, about yourself! *
Your answer
Do you have any specific vision pertaining to the LGBTIQ movement in Kerala? If yes, kindly brief! *
Your answer
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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