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    Dear Applicant,: Application Form Media For Change 2010

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    api-26153714
    This document is an application form for a "Grassroots Media for Social Change" course. It requests information from applicants such as their name, age, organization, address, qualifications, experience, expectations for the course, and how they intend to use what they learn. It also contains confirmation that applicants have obtained support from their organization to apply puppetry skills learned in the course. The form must be completed and emailed by April 30th, 2010 for consideration in the program.

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    Dear Applicant,: Application Form Media For Change 2010

    Uploaded by

    api-26153714
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    This document is an application form for a "Grassroots Media for Social Change" course. It requests information from applicants such as their name, age, organization, address, qualifications, experience, expectations for the course, and how they intend to use what they learn. It also contains confirmation that applicants have obtained support from their organization to apply puppetry skills learned in the course. The form must be completed and emailed by April 30th, 2010 for consideration in the program.

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    This document is an application form for a "Grassroots Media for Social Change" course. It requests information from applicants such as their name, age, organization, address, qualifications, experience, expectations for the course, and how they intend to use what they learn. It also contains confirmation that applicants have obtained support from their organization to apply puppetry skills learned in the course. The form must be completed and emailed by April 30th, 2010 for consideration in the program.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    21 views2 pages

    Dear Applicant,: Application Form Media For Change 2010

    Uploaded by

    api-26153714
    This document is an application form for a "Grassroots Media for Social Change" course. It requests information from applicants such as their name, age, organization, address, qualifications, experience, expectations for the course, and how they intend to use what they learn. It also contains confirmation that applicants have obtained support from their organization to apply puppetry skills learned in the course. The form must be completed and emailed by April 30th, 2010 for consideration in the program.

    Copyright:

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    Application Form Media for Change 2010

    Dear Applicant,

    As a prelude to the Grassroots Media for Social Change course, we would appreciate if
    you could fill in the following form and email it to us by 30th April, 2010. The purpose of
    this form is to help us get to know you and your expectations, so that we can assess
    whether this program is appropriate for you. Please email the form to Anurupa Roy or
    Kanika Sinha at pravah.media4change@gmail.com

    Feel free to add anything else that you think we should know.

    Applicant Profile
    1. Name: 2. Age:
    3. Organisation:

    3. Residential address:

    3. Landline no.: 4. Mobile no.:


    5. E-mail:
    5. Educational Qualifications:

    6. Work experience
    a. Total number of years:
    b. Current role in your organisation:

    c. Brief description of various roles and responsibilities held (most recent one first):

    7. Your expectations from this program:

    8. How do you intend to use this program’s learnings in your workplace?

    9a. If you are a youth facilitator/teacher/media professional:


    Please mention the training programs and campaigns you have conducted so far and
    the profile of the audience for whom these programs were conducted:

    9b. If you are a young active citizen:


    Please mention issues/campaigns/workshops etc. that you have addressed/participated
    in through your active citizenship:

    10. What do you think are your strengths and areas of development as a youth
    facilitator?

    11. What is your background and experience with using media for social change?

    12. What are some of the pressing issues that you feel the youth of your community
    should be engaged with

    Using Puppetry for Social Change


    Application Form Media for Change 2010

    Applying Learning
    I confirm that I have obtained requisite agreement from my organization to support all
    facilities required, including time and resources to apply the use of puppetry in my work
    in the community.

    Course fee will be paid by


     Cheque
     Demand Draft

    I have read the course requirements and am in agreement with them.

    Signature Date, Place

    IMPORTANT: International applicants must arrange for travel-related needs themselves


    (passport, visa, vaccines, insurance and any other requirements).

    Thank you for taking the time to let us get to know you better.
    We are looking forward to meeting you soon.

    Warm regards,

    Anurupa and Kanika


    Media for Change – Using Puppetry for Social Change
    - A collaboration of Kat-Katha and Pravah Learning Voyages

    Using Puppetry for Social Change

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