Personal Information Form- Provision of Interns

DFID is an organisation which values diversity. We will not use this information to influence hiring decisions. DFID will only use or send generalised summaries of the information and it will be completed anonymously.

It is not our policy to disclose any information you provide but DFID as a Data Controller, is bound by the Data Protection Act 1998 which gives rights to any individual in respect of personal data held about them. These rights include the personal information held on both electronic and paper format. For more information on Data Protection Act 1998 http://insight/icsd/default.asp?http://insight/icsd/helping_you/ogu/legal/dp_summary.htm

The purpose of this form is to better understand applicant’s background and will be helpful for this recruitment process. . We would like all applicants to provide the following information to support application. While we encourage you to complete this form, if you are not comfortable answering any of questions below, please feel free to leave them blank.

Thank you.

Age group

Under 25 years □ 25-34 years □ 35-50 years□ over 50 years□

Caste/Ethnicity

Madeshi Dalit □ Pahade Dalit □

Madeshi Janajati (relatively disadvantaged)[1] □

Pahade Janajati (relatively disadvantaged)[2] □

Madeshi Janajati (relatively advantaged)[3] □

Pahade Janajati (relatively advantaged)[4] □

Madeshi middle castes (relatively disadvantaged) [5]□

Madeshi middle castes (relatively advantaged)[6] □

Madeshi Brahman/Chettri[7] □ Pahade Brahman Chettri[8]□

Newar

Muslim □

Other □

Sex

Male □ Female□ intersex, third gender, transgender□

Religion

Regional origin (where you gave your SLC exam)

Far Western region □ Mid Western region□ Western region□ Central region □

Eastern region □

Other (outside Nepal) □

Disability Yes No

If yes please provide brief details:

I confirm the information I have provided above is true.

Applicants name:

Signature

[1] Tharu, Kumal, Jhangad, Dhanuk

[2] Chepang, Raji, Raute, Majhi, Tamang, Baramu, Hayu, Phari, Sunuwar, Thangmi, Yakha Raute, Kumal, Dunuwar, Magar, Adibasi, Kisan, Kusunda Munda, Bhujel.

[3] Santhal, Satar, Gangai, Rajbhanshi

[4]Rai, Limbu, Sherpa, Bhote, Dhimal, Jirel, Hyalmo, Walung, Gurung, Meche, Byansi, Chantal, Dura, Lepcha, Thakali

[5] Kahar, Lodha, Nuniya, Lohar, Rajbhar, Mallah, Bing, Bhediyar, Bote, Darai, Dhuniya, Kamar, Mali, Kewat

[6] Sonar, Kurmi, Kanu, Kumhar, Badhai, Thakur/Hasam, Yadav, Barai, Koiri, Teli, Haluwai, Kalwar, Sudhi, Baniya, Bangali, Jaine, Nurang, Punjabi, Marwadi

[7] Madhesi Brahman, Rajput, Kayastha, Bhumihar

[8] Pahade Brahman, Chettri, Thakuri, Sanyansi