Regional Institute of Medical Sciences
Imphal, Manipur

Online Application for Appointment of Professor of Orthodontics nd Dentofacial Orthopaedics - 1 No. (UR)

This form is to be filled up after scanning of all the required documents mentioned in the previous instruction page. .
( This site works best with Google Chrome )

Applicant Category:        
Post Applied for: Professor of Orthodontics and DentofacialOrthopaedics      
Category:   Are you Government Employee?
Personal details:        
Name of the Candidate: (Name should be exactly what you entered in Class X certificate)
Gender:   Date of  birth
Father/Mother/Husband Name:      
Mobile No:   Email
Nationality:      
Address for correspondence :        
Address:  
State:   Pin Code:
Permanent Address:
Address:      
State:   Pin Code:
         
Uploads:        
*
   
* Class X School Name:
* Class X Passing Certificate:
(Max file size:400kb)		 * Class X Marksheet:
(Max file size:400kb)
 
* Class XII School Name:
* Class XII Pass Certificate:
(Max file size:400kb)		 * Class XII Marksheet:
(Max file size:400kb)
   
* Institution from which BDS was Completed:
* BDS Passing Certificate:
(Max file size:400kb)		 * BDS Marksheet:
(Max file size:400kb)
   
* Institution from which Post Graduate Degree in Dental Surgery in the concerened subject was Completed:
* Certificate of Post Graduate Degree in Dental Surgery in the concerened subject:
(Max file size:400kb)		 * Marksheet of Post Graduate Degree in Dental Surgery in the concerened subject:
(Max file size:400kb)
   
* Teaching Experience Certificate (5 years Teaching experience in the speciality as Associate Professor / reader in a Dental College after requisite Post Graduate qualification) :
(Max file size:400kb)		 Experience Details (in short)::
   
* Passport size Photo:
(Max file size:400kb) Photo must be Clear and properly visible		 * Signature:
(Max file size:400kb) Signature must be Clear and properly visible
Declaration:    
I declare that all the above given information is true to the best of my knowledge. Note: To reduce pdf file size, click here