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Training Programmes

Training Programmes



|Views: 140 |Likes:
Published by kalloornator
Individualised Training Programmes meant for health professionals.
Individualised Training Programmes meant for health professionals.

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Published by: kalloornator on May 18, 2008
Copyright:Attribution Non-commercial


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Registration Form
 Name : _____________________________________________________ Father’s / Husband’s Name :____________________________________ Course applied for :__________________________________________ :____________________________________ 
Present Add : ___________________________________________________________________  _____________________________________________________________________________E-mail ID: ________________________________ Tel No.______________________________ Date of Birth: ______________________________ Age : ______________________________ State of Domicile : __________________________ Mother Tongue :______________________ Marital Status:______________________________ Date of Marriage : ___________________ Children, if any (with age): _______________________________________________________ Other Dependents:______________________________________________________________ 
Family BackgroundEducational LevelOccupation / DesignationFatherMotherSpouseBrotherSister
Are you related / known to anyone now employed by Rejuv Health Care Services Pvt Ltd.If yes, sate position, department & relationshipHeight : ________________ Weight : _________________ Eyesight : ____________________ 
Affixyour PassportSizePhotograph
Have you any physical disability? If yes, give details.____________________________________________________________________________Have you suffered any major illness / undergone surgery in the past? If yes, give details.
Languages Known :
Speak: ________________________________________________________________________ Read: ________________________________________________________________________ Write: ________________________________________________________________________ Do you own a vehicle? If yes, two / four wheeler ________________
DETAILS OF EDUCATIONCert/DegreeSchool/CollegeLocationJoiningDateLeavingDateSubjectMark orDivisionOther Qualification : _ 
 ___________________________________________________________ Computer Knowledge : ___________________________________________________________ Extra curricular activities :_________________________________________________________ 
EMPLOYMENT DETAILSName of Co.worked forDurationFrom ToDesignationReason forLeavingGross Salary
On Leaving On Joining
Have you ever applied to us before? If so, give details.____________________________________________________________________________ 
Any additional information which you may desire to furnish._____________________________________________________________________________ _____________________________________________________________________________  Reason of doing course : ___________________________________________________________________________  ___________________________________________________________________________ References other than relatives:1. Name :________________________ Age :_________ Designation:___________________  Company : ____________________ Address with Pin code : ________________________ _____________________________ Phone : (o) ______________ (R) _______________2. Name :________________________ Age :_________ Designation:___________________  Company : ____________________ Address with Pin code : ________________________ _____________________________ Phone : (o) ______________ (R) _______________
I hereby solemnly affirm & declare that the statements made above are true & that I haveconcealed nothing about myself.Date : _______________________ Signature of Applicant : ____________________________ 
Dhanwantri Kerala Ayurved Training Program

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