Application for the post of Nursing Aid

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* 1. Full Name:

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* 2. Age:

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* 3. Gender

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* 4. Email Address :

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* 5. Mobile Number :

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* 6. Native place :

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* 7. Native State

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* 8. Current Location : City

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* 9. Current Location : State

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* 10. Language Proficiency

Hindi

Telugu

Other (please specify)

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* 11. Educational Qualification:

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* 12. Currently Working?

Yes

No

If yes, Name of the Organisation, Location, and Designation :

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* 13. Total years of working experience

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* 14. Total years of experience in nursing care

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* 15. Do you have experience in community mobilization/community outreach activities

Yes

No

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* 16. Work experience (name the organizations you worked at in descending order)

1

2

3

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* 17. Are you willing to travel for home visits with the project team in Hyderabad and Medchal Malkajgiri districts of Telangana (About 5 – 6 days a week)

Yes

No

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* 18. Are you willing to potentially work flexible hours

Yes

No

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* 19. Current Annual Salary

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* 20. Expected Annual Salary

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* 21. Upload your Resume/CV :

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* 22. Covering letter (optional)

100% of survey complete.