SNIMS Careers - Application Form

Application Form

Job ID	JOB-0032
Application for the Post	Professor/HOD (Dermatology)

PERSONAL INFORMATION

Name (as per official records)

Father's / Husband's Name

Gender

Date of Birth

Age

Nationality

Religion

Caste

Blood Group

Marital Status

Mobile

Alternate Mobile (optional)

Photo (File Type: jpeg, png, jpg & Size: Less than 2MB)

Preferred Joining Date

Permanent Address

Present Address

Same as permanent address

Family Details

Name	Age	Relationship	Occupation
				+

Academic Details

Course	Specialization	Period	Institution	Board / University	% of Marks	Year of Passing
							+

Professional Registration (if any)

Registration No

Council

Certificate Courses Attended (if any)

Course	Conducted By	Duration	Year
				+

Employment Record

Leave "To" empty if you are currently working there.

Institution / Company	Department	Designation	From	To	Last Drawn Salary	Reason for Leaving
							+

Total Years of Experience

Years of Hospital Experience

Major Curricular / Extra-curricular Achievements

Languages Known

Language	Read	Write	Speak
				+

References

1 reference is mandatory *

Name	Designation	Institution	Contact	Email
					+

Salary Expectation (per month)

Emergency Contact Name

Emergency Contact No

Upload your CV (pdf, doc, docx & Size: Less than 2MB)

Declaration

I declare that the statements made by me in this application are true and complete. Any false statement or dishonest answer to any question in this application may result in the cancellation of my candidature or the termination of my employment.

I further declare that no criminal or civil charges are pending against me at this point of time.

In accepting employment, I agree to abide by the rules governing employees of Sree Narayana Institute of Medical Sciences (SNIMS). I consent to a physical examination before employment and to such further examinations as may be required.

I authorize SNIMS to use the information provided for recruitment and verification purposes, and to share it with authorized third parties (such as background verification agencies and my references) where required for this purpose.

I Agree

How we can help.

Interested candidates please send your CV to [email protected] Shortlisted candidates will be contacted from the HR Department