GRAAM Intern/Volunteer Application Form

GRAAM Intern/Volunteer Application Form

Grassroots Research and Advocacy Movement

This document carries three sections:

Section 1 is the application form. The intern needs to fill the form and send the same to the given mail id in the site. Intern should keep their answers short. Short answers, likeYes or No should be answered in ‘Yes’ or ‘No’ only. Details, only if asked should be given.

Section 2gives the details about the Internship Fees and other Expenses.

Section 3 is the ‘Terms ad Conditions’ of the Internship Programme with GRAAM. All the interns are requested to give due attention to it and provide date, name and place in disclaimer note. In absence of name, date and place in the disclaimer note, the form will not be considered for the internship. The intern should sign the disclaimer note after joining the internship with GRAAM in a hard copy.

Section 1: Application Form

(for internship/fellowship/volunteer/block placement programme)

1. / Name of the applicant
2. / Age
3. / Gender
4. / Contact Number
5. / Email
6. / Permanent Address / City:
State:
Country
Pin/ZIP
7. / Emergency Contact / Name:
Relation with the person:
Contact Number
Address:
8 / Languages Known / Language / Understand / Speak / Write
9.a. / Do you have any type of disability Status?
9.b. / If yes, then please mention the type of disability and required assistive aids and accommodation during the program
10.a. / Are you currently a full-time student?
10.b. / If yes, then level of education / Please tick the appropriate box / Level of Education
Graduate
Post Graduate
PhD
Diploma
Others
11. / Name of the Institution/University
12. / Address of the Institution/University / City:
State:
Country
Pin/ZIP
13. / Details of Faculty Mentor (if allocated) / Name of the Mentor:
Position:
Department:
Email Id of the Mentor:
14. / Interest Areas for association with GRAAM / Please tick the appropriate box / Area of Interest
Research
Topic of interest (if any):______
Advocacy
Topic of interest (if any): ______
CSR
Media and Documentation
Topic of interest (if any): ______
Social Entrepreneurship
Other
15.a. / Total Period of Internship (Minimum period of internship should be more than 3 weeks)
15.b. / Starting date
15.c. / Ending date
16. / Why do you want to join GRAAM for internship?
17. / Preference for location of internship (the student might have to visit other areas for the purpose of work) / Please tick the appropriate box / Preference for Location
Bangalore
Mysuru
18. / Do you want GRRAM to arrange for your accommodation during the period of internship? (cost to be borne by the intern)
In Bangalore, the PG cost varies between Rs.8000/- to 12,000/- per month. In Mysuru, accommodation in the organization's hostel could be made (sharing basis), which will cost around Rs.10,000/month (inclusive food) / Please tick the appropriate box / Accommodation Arrangements
Yes
No, I live in Bangalore/Mysuru
No, I will make my own arrangements
19. / Current employment status / Please tick the appropriate box / Employment Status
Full time
Part time
Not Employed
20.a. / Have you worked full/part time before
20.b. / If you had worked/are working full/part time, then provide information about your most recent paid position held / Position Held:
Name of the Organization:
City:
State:
Country:
21.a. / Do you have any previous internship experience?
21.b. / If yes, give details
(If more than 1, then provide the same details for them also) / Organization:
Period of internship:
Project Title:
Responsibility Held:
22. / Professional References (Two only) / Name / Contact Number/Email Id

Intern have to submit following enclosures with this form to be considered for the internship with GRAAM.

(a)Statement of Purpose(SOP) indicating area of interest, relevant skills, experience and motivation for applying to this programme need to be given by the Intern. This should not be more than 500 words.

(b)Electronic version of CV

(c)Scanned Copy of Student Identify Proof

(d)Scanned copy of any of the following:

-Bonafide Certificate issued by the institution, or

-Letters of Reference/Recommendation by an institutional authority, and

(e)Scanned copy of documentary proof about Educational Qualification(last year’s mark sheet/passing certificate)

Refer the following pages for internship fees for national and international students.

Section 2: Internship Cost

Internship Cost for Indian Nationals (in Indian Rupees)

Sl No / Particulars / Cost Per Month
1 / Admin Charges / 2000
2 / Internship Fees / 3000
Total in INR / 5000
3. / Boarding and Lodging cost would be extra / In Bangalore, the PG cost varies between Rs.8000/- to 12,000/- per month. In Mysuru, accommodation in the organization's hostel could be made (sharing basis), which will cost around Rs.10,000/month (inclusive food)

Internship Cost for Foreign Nationals (in Indian Rupees)

Sl No / Particulars / Cost Per Month / Cost Per Unit / Sub Total / Remarks
Internship Fee / 15000 / 15000
Boarding and Lodging Expenses / 30000 / 30000 / Twin Sharing Accommodation with Continental Breakfast and Executive Meals (Vegetarian)
10000 / Dormitory Accommodation with simple Indian Cuisine (vegetarian)
Travel Coordination Charges / 5000 / 5000 / VISA, travel orientation, correspondence with intern’s university /institutions etc.

Note:

a. GRAAM would provide minimum financial assistance (Stipend) for Indian Students. A separate application should be submitted to avail the benefit. Decision would be final with GRAAM regarding the stipend.

b. Intern is expected to budget approximately Rs. 2000/- to 5000/- per month in case internship involves field visit activities.

c. There will be free access to internet in the GRAAM campus.

d. Travel expenditures are based on actuals for foreign students.

e. This costing is valid till 31th March 2017.

Section 3

GRAAM Internship / Fellowship / Volunteer Programme Conditions

  1. Candidate means a person applying for or selected for internship, fellowship, volunteer, block placement or any such programme notified or accepted by GRAAM from time to time
  2. Programme means internship, fellowship, volunteer, block placement or any such programmenotified or accepted by GRAAM from time to time
  3. Timing: The dates of this programme are non-negotiable; candidate are expected to attend the entire duration of the programme and to work full time on the internship.
  4. Research Assignment and location: Though candidate’s background and preferences are considered while assigning the topic to be researched, there is no guarantee that they will be assigned the topic and location of their preference.If selected, candidate should be willing to work on the research topic and field location assigned.
  1. Status: Although candidate is not considered as a staff member of GRAAM, thou shall be subject to the rules, regulations and practices of the organization and will be working as per the guidance / instructions of the Executive Director or the authority delegated by him.
  1. Medical Health and Life Coverage: GRAAM accepts no responsibility for costs or fatality arising from illness or accidents incurred during the internship; therefore, candidate shall carry adequate and regular medical and life (accidental death & dismemberment) insurance or candidate shall make my own arrangements to meet the expenses related.
  1. Passport and Visas (for foreign studnets): Candidate is responsible for obtaining necessary passport and visas when required. GRAAM will issue only a letter stating acceptance of an individual as an interns / volunteer / fellow and the conditions governing the internship.
  1. Confidentiality and Publication of Information: Candidate shall respect the confidentiality of information that he/she will collect or exposed to at GRAAM. No reports and papers willbe published based on the information obtained from GRAAM without the explicit written authorization by the Executive Director.The personnel of GRAAM who has mentored the intern and other personnel supported for the intern in the subject matter should be provided the authorship in the publication that intern is going to publish using the data, information, knowledge, guidance that are obtained during the internship.
  2. Right of Publication: Intern shall have no-objections, as well as provides complete right to GRAAM / the mentor to take forward the work, data, analysis, paper, concept notes, reports, proposal, formats, designs and / or any such intellectual outputs and come out with publications.
  1. Professional Ethics & Confidentiality: Candidate will not divulge to any person or utilize any of the Organization’s secrets or other related information (which you may possess by reason of your association with the Organization) outside the Organization. Candidate shall maintain the confidentiality of any and all proprietary information of which he / she gain knowledge or possession as a result programme with the Organization. Candidate shall not disclose such proprietary information to any person / organization. The term, ‘proprietary information’ shall mean all Organization information whether in oral, written, diskette, graphic or machine readable form, including but not limited to all non-public lists of partner organizations, clients, customers, contractors, vendors, intermediaries, prices, business plans, strategic plans, concept notes, research proposals, data, templates for data collection, template of budget, project/activity/organization budgets, reserves or other non-public financial information, client base, manuals, designs, procedures, formulas, discoveries, inventions, improvements, concepts, ideas, future plans and budgets, unannounced organizational or staffing changes, financial analyses, management information, technical data and data of studies conducted or being conducted by the Organizations.
  2. This condition of confidentiality shall continue to remain in force even after candidate complete internship / programme in the organisation.
  3. Employment Prospects: The GRAAM internship (programme) is not connected with employment and there is no expectancy of such. Candidates cannot apply for posts advertised internally to GRAAM staff during the period of internship.

Disclaimer
I certify that the information I have provided in this application are true and complete to the best of my knowledge. I understand that false or misleading information in my application may result in cancelling my candidature from the programme.
I have read, understood and follow all the terms, conditions and guidelines provided in this form.
Signature: Date:
Name: Place:

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