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ACTION EXCHANGE (ACTEX) FELLOWSHIP APPLICATION 2012 Cohort

Contact Information Name Male / Female M/F Date of Birth dd/mm/yyyy Civil Status Nationality Street Address Town & Zip/Postcode Home Phone Country of residence Work Phone E-Mail Address Skype Name Person to Notify in Case of Emergency Name Street Address Town & Zip/Postcode Home Phone Work Phone E-Mail Address Academic Background Are you currently enrolled as a student? Y/N Degree Field of Expertise Educational institution Date enrolled dd/mm/yyyy Date of Graduation dd/mm/yyyy

www.actionexchange.org Availability Dates Date available Duration of availability Is your availability flexible?

dd/mm/yyyy

Resume Please attach your resume to this document, or attach it separately in an email. SKILLS, EXPERIENCE AND COMPETENTIES Summarize special skills and qualifications you have acquired from your education, employment, previous volunteer work, or through other activities.

How would you use these skills to create a better world? Please be creative.

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Summarize any previous work in non-profits, social enterprises and other volunteer experience.

Describe a situation time where you had to adapt to what was changing around you. How did you deal with the situation?

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Describe a time when you have worked as part of a team to complete a piece of work how did you ensure the team worked effectively?

Why are you interested in becoming an ActEx Fellow? Why are you suited for the ActEx Fellowship?

www.actionexchange.org What languages do you speak? Please indicate if you are conversational, professional or fluent in the boxes below. Language Speak Read Write

AGREEMENT AND SIGNATURE By submitting this application, I affirm that the facts set forth in it are true and complete. I understand that if I am accepted as a fellow, any false statements, omissions, or other misrepresentations made by me on this application may result in my immediate dismissal. Name Date

www.actionexchange.org ACTION EXCHANGE FELLOWSHIP CONTRACT INTRODUCTION TO ACTION EXCHANGE Action Exchange is an international, nonprofit organization 501 (c)(3) dedicated to reducing poverty in India and promoting cultural understanding and productive relationships between India and the United States. ActEx works through hand-picked, local partners with proven success in addressing the economic, social and environmental challenges of Indias poor. ActEx seeks to build a committed network of dedicated talented, social entrepreneurs in the United States, Europe and India, in order to mobilize human and financial resources to establish creative and sustainable solutions to poverty reduction. VISION Action Exchange envisions a more connected world in which cultural understanding, social entrepreneurial innovation and international collaboration are the engines that drive the reduction of poverty, social injustice and environmental degradation. To realize this vision, Action Exchange is guided by the following five-part mission: MISSION 1) To send talented individuals to India to conduct internships and research with charitable Indian organizations which address the economic, social and environmental causes of poverty; 2) To provide technical and financial support to Indian charitable organizations which promote and support social entrepreneurs as a means of reducing poverty in India; 3) To foster cultural understanding between the USA and India by developing a

www.actionexchange.org strong network of program alumni and organizations dedicated to working together to reduce poverty and advance international understanding and goodwill; 4) To promote dialogue, understanding and action to reduce Indian poverty by connecting urban and rural Indians through short and long term exchange programs; and 5) To build partnerships and conduct outreach within India to increase domestic philanthropy for poverty reduction efforts. ACTEX FELLOWSHIP PROGRAM ActExs flagship program the ActEx Fellowship Program matches individuals (Fellows) in the United States and Europe with nonprofit organizations (Partners) in India. Matching is done according to the skills and abilities of the Fellow and the needs of the partner organization. Working closely with Fellows and Partners, Action Exchange facilitates the development of collaborative professional relationships throughout out the fellowship period, and encourages the development of lifelong partnerships between organizations and individuals committed to addressing the causes of poverty in India. ActEx works closely with Fellows and Partners to develop action based research plans that are mutually beneficial. ActEx works with Fellows and Partners to meet university requirements where applicable. During the fellowship period, ActExs Indian and US-based volunteer staff provide support for Fellows and Partners, requiring all parties to submit periodic reports, provide documentation of all activities, and to maintain open channels of communication. ActEx Fellows receive a comprehensive orientation including: insights and guidance related to cultural differences, support with strategic planning for research, exploration of roles and goals for the fellowship period, and training regarding the social media dimensions of the fellowship. At the end of the fellowship period, Fellows prepare a presentation outlining goals, accomplishments, and relevant aspects of collaboration. Action Exchange is a proponent of using social media as a means of documentation, connection, and reflection. Action Exchange asks that Fellows make creative use of these tools to increase exposure, expand networks, and build relationships. ActEX Fellows document relevant aspects of their work and collaboration using a variety of social media tools including: Facebook, Twitter,

www.actionexchange.org blogging and online photo and video sharing. Fellows are required to create a blog for the Partner Organization, to create their own blog, and to contribute to Action Exchanges blog as well. The ActEx Fellowship asks that fellows commit to a period of 3-12 months. Fellows and Partners may consider of extending this commitment prior to the completion of the period if both parties express interest in a continuing professional relationship. Fellows staying for less than six months may apply for a tourist visa. Those who commit to longer than a six-month period must apply for a work visa. Partner organizations pay a livable stipend to the Fellow. Fellows will live simply in basic accommodations. Placements are often in rural environments. ACTEX FELLOWSHIP PROGRAM PARTNERS Action Exchange Partner Organizations represent a diverse range of sectors including health, livelihoods, agriculture and education. They are non profits and social enterprises committed to cross sectoral collaboration. Joining efforts through Action Exchange, social investors, philanthropists, and grassroots organizations in India, provide innovative solutions to social, economic and, environmental problems. Action Exchange partners are evaluated and selected based on demonstrating promise in the areas of Innovation, Social Entrepreneurialism, and Impact, just like ActEx Fellows. Partner organizations work collaboratively with ActEx fellows to expand and strengthen standards of professionalism, innovation, efficiency, growth and impact. Action Exchange continually explores new partnerships with competent organizations in India. BENEFITS OF BEING AN ACTION EXCHANGE PARTNER The benefits of being an Action Exchange Fellows are numerous. Firstly, the ActEx Fellowship Program matches Fellows with creative and impactful non profits and social enterprises who are implementing innovative solutions to Indias social, environmental and economic problems. ActEx Fellows have the opportunity to foster change both within the organizations and within the communities which they work. For those who are interested in pursuing a career in international development and social entrepreneurship the ActEx Fellowship provides hands on grassroots experience, and networking opportunities across sectors. ActEx Fellows are also considered to be valuable assets by the Partner Organizations. ActEx Fellows not only bring a global perspective, but global knowledge, skills and networks that are very valuable to the growth of Indian organizations, and in the alleviation of poverty. ActEx fellows can provide bridges to financial investments, and other valuable resources.

www.actionexchange.org ActExs focus on social media will also be a value added skill set for Partner Organizations. Through the use of social media tools, ActEx Fellows assist Partner Organizations in marketing their products, and services, and telling their stories, to the global online community and the world at large. ActEx sees the relationship between the Fellows and the Partner Organization as a long-term commitment that extends beyond the time frame of the ActEx Fellowship. ActEx is developing an alumni support program that supports prolonged connectivity with ActEx Fellows even after they leave. ROLES AND RESPONSIBILITIES PROJECTS and EVALUATIONS Partner Organizations are expected to be clear about their needs. ActEx Fellows are selected based on skills and experiences that fit the particular needs of their Partner Organizations. However, ActEx Fellows are expected to carry out the responsibilities given to them by the Partner Organizations. Partner Organizations may dramatically change the responsibilities of the ActEx Fellow, only if they contact Action Exchange first. Partner Organizations are expected to work with Action Exchange on developing defined roles and responsibilities for the ActEx Fellow before their arrival. Partner Organizations are expected to elect a mentor for each ActEx fellow. Mentors are the primary providers of support and information for the ActEx Fellows. ActEx Fellows are expected to work with their Partner Organizations to document their work and their progress with the Partner Organizations using Social Media tools such as a blog, Twitter, Picture Sharing, Facebook and Youtube. ActEx Fellows are responsible for setting up and maintaining these systems themselves. ActEx Fellows are expected to teach Partner Organizations how to use these tools, and Partner Organizations are expected to use them on a regular bases. ActEx Fellows are required to submit a blog post, set of pictures, or a video every month. Action Exchange is responsible for making sure ActEx Fellows submit

www.actionexchange.org their monthly media. Action Exchange will use these platforms to evaluate the ActEx Fellows. At the end of the fellowship period ActEx Fellows are required to do presentation of their work and learning to the Partner Organizations and to Action Exchange. They are required to write a paper of 1,000 words describing what they did, how they did, what they learnt, and what they could have done better. This presentation and the paper documents will be given to the Partner Organizations as a reference. ActEx Fellows will also provide written feedback to the Partner Organizations as a form of evaluation. Partner Organizations will also provide written feedback to the ActEx Fellow prior to their departure. Partner Organizations will be evaluated by Action Exchanges Executive Director, Cameron Campbell, through a series of interviews after the ActEx Fellow has left. LENGTH OF STAY AND VISAS ActEx Fellows are required to stay with the Partner Organization for, no less than three months, but can stay as long as a visa will allow them. ActEx Fellows are required to sign a contract for at least three months. ActEx Fellows from foreign countries staying less than 6 months, ActEx will assist in acquiring a Tourist Visa. For Fellows staying more than 6 months to a year ActEx will assist in acquiring a Work Visa. INTERNATIONAL TRAVEL International travel to and from India will be covered by the ActEx Fellow, or by Action Exchange. Partners will not need to pay for travel to and from India. FINANCIAL RESPONSIBILITIES Partner Organizations are required to pay each fellow they receive a monthly stipend of 10,000 INR per month. Partner Organizations are required to pay a one-time fee of 5,000 INR per fellow per year to Action Exchange to support transaction and administrative costs. WORK RELATED LOGISTICS

www.actionexchange.org Partner Organizations are required to arrange affordable housing for ActEx fellows, but are not required to pay for it. Partner Organizations will be responsible for paying for housing, or will have it deducted from their 10,000 INR per month stipend, and used as rent. Partner Organizations will be required to cover work related travel, such as field visits, and work related expenses such as phone, internet, printing, and other administrative costs. Partner Organizations must agree to give ActEx Fellows at least one day off each week. Daily schedules are up to the Partner Organizations to decide and will vary. HEALTH AND WELLBEING Partner Organizations, as representatives of Action Exchange must look after the ActEx Fellows with care and compassion. Partner Organizations are not responsible for ActEx Fellows actions outside of work related environments, but are expected to contact a local representative of ActEx, or Cameron Campbell, the Executive Director of Action Exchange in case of a behavioral emergency. Partner Organizations are expected to provide information about health related resources, such as pharmacies, doctors, and hospitals in the area of work. Partner Organizations are also expected to contact a local representative of Action Exchange, or Cameron Campbell the Executive Director of Action Exchange in case of a health emergency.

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