Prior to Filing out This Form, Please Read The

Navdanya Delhi A-60 Hauz Khas, New Delhi – 110 016 Tel: 91-11-26561868, 26968077, 26853772, Fax: 91-11-27962093 Navdanya Dehradun105, Rajpur Road, Dehradun – 248 001, Uttarakhand, INDIA Tel: +91 – 135 – 2743175 Telefax: +91 – 135 – 2749931

or

NAVDANYA

INTERNSHIP AND VOLUNTEER APPLICATION

Prior to filing out this form, please read the

Earth University (Bija Vidyapeeth) Intern, Volunteer, and Course Participant Guide

*REQUIRED FIELDS (Please limit all answers to 200 words or less)

*First NameAnswer Below
*Surname Name Answer Below
*Date of Birth (DD /MM /YYYY) Answer Below
*Mailing Address Answer below
*Permanent AddressAnswer Below
*EmailAddress Answer below
*Telephone(Include country code) Answer below
*Please describe any medical conditions or special needs that may be an issue during the your internship/volunteering. (Limited mobility, food allergies, etc…) Answer below
*Person to be contacted in case of emergency. Include relationship to you? Answer below
OccupationAnswer below
Organization affiliation, if any? Answer below
*I am applying for internship or volunteer?Answer below
*Start date of internship or volunteering? Answer below
*End date of internship or volunteering? Answer below
*Give a brief overview of your educational and/or professional background. Answer below
*Why have you chosen to intern or volunteer with Navdanya? Answer below
*Desired position or project you wish to undertake? Answer below
*What skills or knowledge would you bring to Navdanya? How will you contribute?Answer below
*What do you hope to achieve during your internship/volunteering?Answer below
*Describe your learning/working style. Are you comfortable working independently with minimal supervision?Answer below
*If any, describe the requirements from your educational institution regarding internships (if any). Answer below
*Are you coming to Navdanya on a scholarship, grant or as a research fellow? If so will you require any special needs from Navdanya regarding research or anything else?Answer below
Hobbies, interests, anything else you would like to share? Answer below
*Where did you learn about the opportunity to intern/volunteer at Navdanya?Answer below
*Have you been affiliated with Navdanya in the past? Answer below
We thank you for your interest in interning with Navdanya. Please return the completed form via email to:
*By typing (or signing and faxing) my name below, Iverify the above and acknowledge I have read the "Earth University (Bija Vidyapeeth) Intern, Volunteer, and Course Participant Guide," and will agree to the Navdanya farm community living guidelines.
X DATE:

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