Internship Application Form Personal InformationName(Required) First Last Phone(Required)Email(Required) Gender(Required) Male Female Other Prefer Not to Answer Other (Gender)Optional if you wish to share your gender description Date of Birth(Required) MM slash DD slash YYYY Address(Required) Street Address Address Line 2 City County / State / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÃ…land Islands Country Employment and EducationWhat is your highest qualification?(Required) Graduation Post Graduation Mphil or PhD Others If others, please specify your educational details College or University from where you graduated?(Required) What was your discipline of study for graduation?(Required) Which college or University you did your post graduation from? (if applicable)(Required) What was your discipline of study for post graduation?(Required) If your highest qualification is Mphil or PhD, please mention the discipline and University Current status Employed Student Freelancer If student, please specify the details of your university If you are employed, please mention the name of your employer Area of InterestIs this internship part of your graduate or post-graduate studies, a mandate by your University?(Required) Yes No What is the duration of internship with BALM or The Banyan?(Required)Please complete as appropriate to your situationDuration of engagement (days) Add RemoveType of Internship(Required) Block ( all days in the week) Concurrent (number of days in a week) Start date of internship(Required)As we filter all applications, we would need 14-working days to place you from the date of submission MM slash DD slash YYYY Last date of internship(Required)As we filter all applications, we would need 14-working days to place you from the date of submission MM slash DD slash YYYY How would you prefer to engage with BALM(Required) On Site Remote Hybrid HiddenWhich Centre would you be interested in at BALM and The Banyan (First Priority)(Required)Please choose your first priority for interning with BALM. Depending upon the availability we will connect you with the appropriate centre. Please note that the Banyan project includes Emergency & Recovery Care Centre, Home Again, Outreach & aftercare programmes, Clinical Services, Social Needs & Livelihoods, and Research The Banyan Project - Tamil Nadu The Banyan Project - Kerala The Banyan Project - Maharashtra The Banyan Project - Karnataka The Banyan Project - Andhra Pradesh Centre for Social Action and Research, Kovalam (Hybrid) Centre for Trauma Studies & Innovation Centre for Child and Adolescent Mental Health, Kovalam, Tamil Nadu Which Centre would you be interested in at BALM and The Banyan (First Priority)(Required)Please choose your first priority for interning with BALM. Depending upon the availability we will connect you with the appropriate centre. Please note that the Banyan project includes Emergency & Recovery Care Centre, Home Again, Outreach & aftercare programmes, Clinical Services, Social Needs & Livelihoods, and Research The Banyan Project - Tamil Nadu The Banyan Project - Kerala The Banyan Project - Maharashtra The Banyan Project - Karnataka The Banyan Project - Andhra Pradesh Centre for Social Action and Research, Kovalam (Hybrid) Centre for Trauma Studies & Innovation Centre for Child and Adolescent Mental Health, Kovalam, Tamil Nadu Communications and Media in Mental Health Centre for Indigenous Mental Health HiddenWhich Centre would you be interested in at BALM and The Banyan (Second Priority)(Required)Please choose your second priority for interning with BALM. Depending upon the availability we will connect you with the appropriate centre. Please note that the Banyan project includes Emergency & Recovery Care Centre, Home Again, Outreach & aftercare programmes, Clinical Services, Social Needs & Livelihoods, and Research The Banyan Project - Tamil Nadu The Banyan Project - Kerala The Banyan Project - Maharashtra The Banyan Project - Karnataka The Banyan Project - Andhra Pradesh Centre for Social Action and Research, Kovalam (Hybrid) Centre for Trauma Studies & Innovation Centre for Child and Adolescent Mental Health, Kovalam, Tamil Nadu Which Centre would you be interested in at BALM and The Banyan (Second Priority)(Required)Please choose your second priority for interning with BALM. Depending upon the availability we will connect you with the appropriate centre. Please note that the Banyan project includes Emergency & Recovery Care Centre, Home Again, Outreach & aftercare programmes, Clinical Services, Social Needs & Livelihoods, and Research The Banyan Project - Tamil Nadu The Banyan Project - Kerala The Banyan Project - Maharashtra The Banyan Project - Karnataka The Banyan Project - Andhra Pradesh Centre for Social Action and Research, Kovalam (Hybrid) Centre for Trauma Studies & Innovation Centre for Child and Adolescent Mental Health, Kovalam, Tamil Nadu Communications and Media in Mental Health Centre for Indigenous Mental Health HiddenWhich Centre would you be interested in at BALM and The Banyan (Third Priority)Please choose your third priority for interning with BALM. Depending upon the availability we will connect you with the appropriate centre. Please note that the Banyan project includes Emergency & Recovery Care Centre, Home Again, Outreach & aftercare programmes, Clinical Services, Social Needs & Livelihoods, and Research The Banyan Project - Tamil Nadu The Banyan Project - Kerala The Banyan Project - Maharashtra The Banyan Project - Karnataka The Banyan Project - Andhra Pradesh Centre for Social Action and Research, Kovalam (Hybrid) Centre for Trauma Studies & innovation Centre for Child and Adolescent Mental Health, Kovalam, Tamil Nadu Which Centre would you be interested in at BALM and The Banyan (Third Priority)Please choose your third priority for interning with BALM. Depending upon the availability we will connect you with the appropriate centre. Please note that the Banyan project includes Emergency & Recovery Care Centre, Home Again, Outreach & aftercare programmes, Clinical Services, Social Needs & Livelihoods, and Research The Banyan Project - Tamil Nadu The Banyan Project - Kerala The Banyan Project - Maharashtra The Banyan Project - Karnataka The Banyan Project - Andhra Pradesh Centre for Social Action and Research, Kovalam (Hybrid) Centre for Trauma Studies & innovation Centre for Child and Adolescent Mental Health, Kovalam, Tamil Nadu Communications and Media in Mental health Centre for Indigenous Mental Health Do you have any preferences for location?Tamil NaduKeralaMaharashtraAndhra PradeshKarnatakaNoneWhere did you learn about BALMPlease let us know where you heard about BALM, as this will help us reach more people in the future. Social Media News Word of mouth Subscription Website Google search Other OtherPlease define where you heard about BALM Language ProficiencyWritingSpeakingReading Add RemoveDetail questionsWhat evoked interest in working with BALM/ BanyanTell us about yourself?If you have any disability or special needs, please let you know how and if we can enable you in anyway?Please share any voluntary work or activities/co-curricular you have been been a part of?(optional)CV uploadOptionalMax. file size: 2 GB.DeclarationI hereby declare that the details and information gives above are true and complete to the best of my knowledge. I agree to the declarationStatement by BALM and the Banyan(Required)We believe in imparting knowledge & education which is free in cost, however we appreciate any donation in kind or cash that you are willing to contribute to our organisation. Available on request. Yes, I am interested No, I am not interested Untitled Δ Thank you for reaching out to us. For any queries please send an e-mail to ‘internship@balm.in’ with the title ‘ Internship: Query’
