1. Family Name:
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Given Names:
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2. Sex:
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3. Marital Status:
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4. Date of Birth:
(day/month/year)
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5. Place of Birth:
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6. Present Nationality:
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7. Permanent Address:
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8. Present Address:
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Telephone No.: |
Telephone No.: |
Fax No.: |
Fax No.: |
9. In case of emergency, notify: |
Name:
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Address:
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Telephone No.:
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10. Knowledge of Languages: |
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Read |
Write |
Speak |
Language |
EasilyNot Easily |
Easily |
Not Easily |
Easily |
Not Easily |
English |
Easily Not Easily |
Easily Not Easily |
Easily Not Easily |
Hindi |
Easily Not Easily |
Easily Not Easily |
Easily Not Easily |
Bengali |
Easily Not Easily |
Easily Not Easily |
Easily Not Easily |
Other:
(Please Specify) |
Easily Not Easily |
Easily Not Easily |
Easily Not Easily |
11. Word Processing/ Computer Skills: Yes No |
12. Higher Education (College/ University) |
Institution
Name/ Place and Country |
Attended From/To |
Degrees |
Major Subject of Study |
Mo./Year |
Mo./ Year |
Obtained |
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Degrees Expected |
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13. Employment: Please describe any previous practical experience you may have had, giving full
details of your duties. |
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14. Career Plans: |
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15. Other Relevant Information: |
a) University Scholarships or Academic Distinction: |
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b) Publications (if any): |
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c) Have you ever applied for regular employement ? Yes No |
If Yes, Please give dates and name of Agency:
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d) Have you ever been arrested, indicted, or summoned into Court as a defendant in a criminal proceeding, or convicted, fined, or imprisoned for the violation of any law (excluding minor traffic violation)? Yes No |
16. Internship Period:
Please indicate your availability for Internship (periods of upto a maximum of six months) |
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17. Preferred Work Assignment:
Please indicate by numbering in order of preference three main areas in which you would like to be considered for an internship. |
Agriculture Demography Engineering Journalism Sociology Translation & Terminology
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Computer Science Economics Environment Mass Media Statistics |
International Relations Energy Finance Political Economy Public Administration |
18. Endorsement Institution (ATTACH FILE)
(Submit original of endorsement letter with this application) |
19. References:
Please list three persons not related to you, who are familiar with your character and
qualifications: |
Full Name and Title |
Address |
Business or Occupation |
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20. I certify that the foregoing statement and answers are true, complete and correct to the best of
my knowledge and belief. Upload Signature Date: |