Application for Medical Officers (Adventure Programs 2016)
Name of the Applicant
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Father's Name
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Complete Postal Address with City, Pin Code
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State
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Mobile Number(10 Digits)
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Valid Email Address
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Gender
Qualification as Medical Officer (MBBS, MD, MS or other Specialization)
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Please mention Currently Working (Junior Resident, Senior Resident, Private Practice or Consultant)
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Have you attended any National Himalayan Trekking Expedition with Youth Hostels Association of India ?
Do you have any Experience / training in trekking mountaineering & other allied activities ?
Languages spoken fluently/ conversational
Which date shall be convenient for you to arrive at Base Camp (subject to availability)? Write date in DD-MM-YYYY Format
MM
/
DD
/
YYYY
Please select Program preference for posting as Medical Officer. (Note: You can be posted at one or multiple higher camps in the Adventure Program of your preference.
Maximum period of service you can offer for the Trekking Expedition (Minimum periods is 14 days). Please write number of days below.
Your answer
Do you have the knowledge with regards to First Aid in wilderness and High Altitude illness. If No, then please visit any authentic website for eg. UIAA (http://www.theuiaa.org/)
I undertake to abide by the discipline of the Programme and render my services in any camp for the period offered as required by the Field Director or his nominee. I also certify that I am not suffering from any aliment which may be a handicap in rendering my services. I further certify that I have informed my parents/ guardians about my joining the expedition as a Medical Officer.
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