World Vision International Nepal
(Application Form for Internship – 2015-2016)
…………………………………………………………………………………………………………………………………………………………….
(Please provide short and clear answer on the following questions).
A. Biographic Information:
Name of the Applicant:
Gender:
Date of Birth (AD):
Age (Years):
Place of Birth
VDC/Municipality: ___________
Permanent Address
(/Municipality, District):
Marital Status:
District: __________________
Citizenship No.:
Village: ________________
Present
Address:
Ward No: _________________
VDC/Municipality: ___________
District: __________________
Religion:





Hindu
Buddhist
Muslim
Other (Please specify) ____________
Christian
Mobile:
Landline:
Email Address:
Contact Information:
B. Other Information:
1) Church (If you are a Christian):
Pastor's Name:
Church's Name:
Church's Address:
Mobile Number:
Pastor's Contact
Information:
Landline number:
Email:
2) Organization where you are involved (If you are involved with any organization):
Name of the Organization:
Address:
Your current position/ Role:
Head of the organization (Position):
Name:
Email:
________________________
Mobile:
Landline:
Have you informed to the head of the
organization


Yes
No
1
3) What particular technical areas of WVIN are you interested in? Please tick only ONE





Development
Child Sponsorship
Information & Technology
Human Resource (People & Culture)




Finance
Design Monitoring & Evaluation
Communication & Advocacy
Child Protection
If you have any other interest, mention:
_____________________________
C. Academic Qualifications:
Level
Major Field
Institution
D. Major Training/Workshop attended:
Name of Training/
Dates
Workshop/ Seminar, etc.
(From-To)
Date (from - to)
Result
Major focus/
Subjects
Venue/ Location
Organizer /Institute
Major
Responsibilities
Date (from - to)
E. Work Experience (If any)
Employer /Organization
Position
F. General:
Please write in a few sentences why you want to be part of the WVIN's Internship Program:
What do you know about WVIN?
Please describe your involvement in the Church/Organization:
2
G. Language Competencies:
Language
Level of spoken competence
(e.g. basic, intermediate, fluent)
Level of written competence
(e.g. basic, intermediate, advanced)
Nepali
English
Others
H. Computer Skills:
Please describe your level of computer literacy, stating applications of which you are competent user.
I.
Referees (Please include Email & mobile number):
S.N. Name of the
Referee
Post & Church/
Organization
Contact Number
Email
1.
2.
The above information I have provided here is correct and true.
Applicant’s Signature: _____________
Date: _____________
3