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Tuesday, 31 December 2019

AHTC - APPLICATION FORM Anti Human Trafficking Club


AHTC -  APPLICATION FORM
Anti Human Trafficking Club

­
                                                                                                                             Date: __________________
1.    Name of the college/Institution:                    _____________________________________________
                                                                                              _____________________________________________
2.    Address:                                                                    _____________________________________________
                                                                                              _____________________________________________
                                                                                              _____________________________________________
3.    Email Id:                                                                     _____________________________________________
                    
4.    Contact No:                                                              _____________________________________________                             
5.    Name of the two Mentors (Faculty)
With contact details                Mentor - 1       _____________________________________________
                                                                                              _____________________________________________

                                                                      Mentor -2          _____________________________________________
                                                                                              _____________________________________________                                                                                                                                                                                                                  ­
6.    Name and contact number of the AHTC Student Members:-            
I.   Co-ordinator                 _______________________________________________________________

II.  Deputy Co-ordinator  _______________________________________________________________

III. Deputy Co-ordinator ________________________________________________________________

  IV. Deputy Co-ordinator________________________________________________________________
  V.    Members                    ________________________________________________________________
  VI.   Members                                   ________________________________________________________________
  VII.  Members                   ________________________________________________________________
  VIII. Members                   ________________________________________________________________
  IX.   Members                    ________________________________________________________________
  X.    Members                    ________________________________________________________________
I hereby express my willingness to start AHTC in our college /institution with the support of ICWO.

Name:-                 __________________________                           Designation:-___________________________
Signature:-          _________________________                             Seal:-




Please send the filled in application to the following address. Thank you very much for your valuable time.

          The Secretary - Indian Community Welfare Organisation – I.C.W.O.
AP-216, 18th Main Road, ‘I’ Block, 6th Street, Vallalar Colony, Anna Nagar West,
Chennai-600040. Phone: 044-26184392, Email: fieldmaster2000@gmail.com

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