Online Application Form
General Manager (IEC), National Health Mission, Uttar Pradesh

 

 

1. Personal Details:

Applicant's Name:
Father/Husband's Name: Date of Birth: (DD/MM/YY)
Gender: Mobile No.:
Email ID: Alternate Contact No.:
Domicile: Category:

2. Address:

Correspondence/ Current Address with Pin Code: Permanent Address with Pin Code

3. Qualification Detials:

* Name of the Degree/ Diploma
Specialization & Principal Subjects
Name of University/ Institute
Mode of Course
Passing
Month & Year
Marks (in %)

 

[+] Additional Qualification: [Please click on (+) sign if you have any other Degree/ Diploma]

 

4. Work Experience: [Please start with current/ most recent experience. If you have worked in more than one area/ post within the same organization, please enter details of the same separately]:

Name of Organisation Designation/ Title alongwith Duration [e.g. General Manager, June-2015 to June-2016] Key Responsibilities
[Mention atleast 3 key responsibilities]
Experience
(in Months)

From (mm/dd/yyyy):

To (mm/dd/yyyy):


[Maximum Characters allowed: 300]
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From (mm/dd/yyyy):

To (mm/dd/yyyy):

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From (mm/dd/yyyy):

To (mm/dd/yyyy):

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[+] Add More Work Experience (4) [Please click on (+) for giving more work experience details]

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[+] Add More Work Experience (14) [Please click on (+) for giving more work experience details]
[+] Add More Work Experience (15) [Please click on (+) for giving more work experience details]

5. Details of Relevant Experience:

Name of Organisation
(Including Years)
Exposure Area Details of Experience Possessed Experience
(in Months)
Experience in Developing and planning of IEC/BCC strategies and materials
[Maximum Characters allowed: 300]
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Experience in Networking and relationship building with different ministries, government departments and development partners for mainstreaming and integration of health issues
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Experience in Developing Monitoring and Evaluation Tools and Strategies
[Maximum Characters allowed: 300]
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Experience in Developing training and capacity building modules on IPC/BCC/SBC communication
[Maximum Characters allowed: 300]
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Experience in Media Planing
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6. Details of Present Compensation (In Rs.):

a. Monthly Salary b. Monthly Allowances: (If any)

 

7. References: (Please provide contact details of three references who have supervised you at work:)

  Referee One Referee Two Referee Three
Full Name:
Correspondence Address:
Professional Relationship with the referee: 
Mobile:
Email ID:

Declaration: I hereby declare that the information furnished above is true to the best of my knowledge and any misrepresentation, falsification or omission of information used to secure employment shall be grounds for rejection of this application and I would liable for legal action, also immediate discharge if I am employed by UPNHM regardless of the time elapsed before discovery.