Daksha Foundation

UMANG – Daksha Program

Volunteer / Teacher / Program Leader Registration

Discipline • Curiosity • Leadership

🕒 Class: 4:30 PM – 5:30 PM

* Arrive 5 mins early.

1. Select Program Session

Session 1: 9 March – 19 March Session 2: 21 March – 31 March Session 3: 3 April – 13 April Available Multiple

2. Select Your Role

Volunteer Subject Teacher Program Leader / Mentor Academic Coordinator

3. Personal Information

Full Name

Gender

Male Female Other

Date of Birth

Age

4. Contact Information

Mobile Number

WhatsApp Number

Email Address

Full Address

5. Educational Background

12th Pass Undergraduate Graduate Postgraduate Other

12th Pass UG Graduate PG Other

Field of Study

College / University

Semester

6. Teaching / Mentoring Area

Teach & guide students (1-5th class) Teach & guide students (6-10th class) Mathematics Physics Chemistry Biology Logic / Reason Personality Dev. Study Skills

8. Skills & Contribution

Teaching students Student mentoring Prog. coordination Event management Social media Content creation

7. Experience

Prior Experience? Yes No

9. Motivation

Why do you want to contribute to the program?

10. Uploads

Attach Photo

Attach Sig

11. Declaration

I confirm that the information provided in this form is correct.
I understand that the UMANG Program classes run daily from 4:30 PM to 5:30 PM, and I will ensure that I arrive at the course center at least 5 minutes before the class begins.

Applicant Name (As Signature)

Date

Submit this form to Email: dakshaa291@gmail.com | WhatsApp: +91 9451510326

Note: Applicants may also take a printout of the completed form for their records and submission at the course center one day before course ( zero day ).

Submission Steps

Fill out all required details above.
Upload your photo and signature.
Click Generate PDF to save your form.
Send the PDF to us via Email or WhatsApp.

Note:

Applicants may also take a printout of the completed form for their records and submission at the course center one day before course ( zero day ).

Email dakshaa291@gmail.com

WhatsApp +91 9451510326