Application Questionnaire

* 1. Personal Information

* 2. Interest & Availability
Indicate your level of interest & availability for a position at CIMBS, New Delhi

* 3. Are you currently based in New Delhi?

* 4. Have you completed the following level of education: MPhil?

* 5. Educational Qualifications:
Courses completed, names of universities & respective years of graduation.
[Course Name]  -  [Name of University]  -  [Graduation Year]   (repeat for each qualification) 

* 6. Are you fluent in Hindi & English?

* 7. Do you have the following certification: RCI?

* 8. Are you interested in working exclusively with an In-Patient Unit?
We attempt to match available postings with the interests of the professionals.
At a given time, postings may be available in the In-Patient, Out-Patient, or both teams.

* 9. Prior Experience with In-Patient Departments
List out your prior experience of working with In-Patient Departments
Format:   [Organisation] - [Designation] - [Activities Conducted] - [Duration]
State: "None" in case Not Applicable.

* 10. Total Post-Qualification Experience
Indicate Years and Months. Exclude internships & trainings.

* 11. Previous Training at CIMBS
Have you previously received training at CIMBS or at a workshop organised by CIMBS?

If yes, specify details below.   If not, state "No".

* 12. Current Place of Work
Specify name of organisation, city & designation
Note: References, if required, may be inquired for at an appropriate time.

* 13. Remuneration
Last Drawn Remuneration (Salary/ Stipend)