Application Form:

SSMK Fellowship on SBC and SRHR

Digital Broadcast Initiative Equal Access (DBI EA)

Applicant Full Detail:

Last Name First Name Middle
Subedi Chandan

Birthdate: mm/dd/yy Mobile no: E-mail:

9848754505 Chandansubedi5@gmail.com
12/11/1994
Permanent Address: Mahendranagar, Kanchanpur, Sudurpashim

Temporary Address: Kathmandu, Nepal

Gender: Citizen: Caste:

Male Nepalese Brahmin

Academic Qualification: Bachelor in Public Health

Questionnaire:
1. Why do you think that you are eligible for the SSMK fellowship? (300 Max. Words)

Being a public health practitioner I have immense interest to work in the field of sexual and
reproductive health. I have currently completed my Bachelors in Public Health and I have been
involved in various activities that directly address's ASRH Issues at community level.

2. What do you aim to achieve after the completion of SSMK fellowship? (300 Max. words)

What level of knowledge do adolescents in schools have regarding comprehensive sexuality

education
 3. What kind of research methodology will be used during SSMK fellowship? Elaborate
(250 Max. words)
Quantitative descriptive cross-sectional study. Students from class 7,8,9 and 10 will be our
study population. Multistage random sampling will be applied. Self-administered questionnaire
will be used.

Date: Signature of Applicant:

2020/3/2