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NIMHR Form

This document is an application format for recruitment on a contractual basis at the National Institute of Mental Health Rehabilitation in Sehore, Madhya Pradesh, India. The application requests information like name, address, education details, work experience, places of residence and an explanation of why the applicant is suitable for the position.

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IT1036 NancyThakur
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29 views2 pages

NIMHR Form

This document is an application format for recruitment on a contractual basis at the National Institute of Mental Health Rehabilitation in Sehore, Madhya Pradesh, India. The application requests information like name, address, education details, work experience, places of residence and an explanation of why the applicant is suitable for the position.

Uploaded by

IT1036 NancyThakur
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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रा य मान सक वा य पन ु वास सं थान, सीहोर

National Institute of Mental Health Rehabilitation, Sehore


द यांगजन सशि तकरण वभाग, सामािजक याय और अ धका रता मं ालय, भारत सरकार
Department of Empowerment of Persons with Disabilities (Divyangjan), Ministry of Social Justice & Empowerment, Govt. of India
परु ाना िजला पंचायत भवन, लन
ू ीया चौराहा, मंडी रोड, सीहोर, म य दे श - 466001
Old District Panchayat Bhawan, Luniya Chauraha, Mandi road, Sehore, Madhya Pradesh – 466001
वेबसाइट / Website: https://nimhr.ac.in, फोन / Phone: 0756-2223960, ईमेल / Email: [email protected]

Application Format for Recruitment of Contractual Basis Paste self


attested
Employment Notification No. Application No. passport
Application for the post of size
photograph
of candidate

1. Name of the applicant


(in capital letters)
2. Father / Husband Name
3. Date of Birth
4. Gender
5. Nationality
6. Religion
7. Category
8. Are you PWD
9. Present Postal Address
10. Contact No.

11. E Mail ID

12. Permanent Address

13. Educational/Technical Exam Name of the Division Percentage Year of Subjects


Qualifications (from 10th or Passed School/College/ of Marks Passing Taken
equivalent and onwards) University

14. Details of Experiences: Details of Salary Name of the Duration Nature


Post held Drawn Organization With dates of duties
(Designation (Pay Band + G.P to
/ Post / be mentioned in
Nature) case of
Govt. Organization)
15. Particulars of places (with periods of residences), where you have resided for more than one year at a
time during the preceding five years. In case of stay abroad, particulars of all places where you have
resided for more than one year after attaining the age of 21 years would be given:
FROM TO Residential address in full (i.e., village, Name of the district Head Quarters of the
thana and district or place mentioned in the preceding column
H.No./lane/street/road and town)

16. Do you have any relatives in


NIMHR
17. Innovative and Developmental
works undertaken
18. Details of published research
articles, if any
19. Significant Achievements

20. Why you think you are suitable


for the post you have applied
for
(Details within one page)

Date:

Place: Signature of the Applicant

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