02

MEDICAL TEACHING INSTITUTION

Backside
KHYBER COLLEGE OF DENTISTRY, PESHAWAR Attested
Photographs
APPLICATION FORM (FOR NON DOCTORS)

APPLICATION FOR THE POST OF _________________________________________

1. Name (In Block Letters):

): __________________
2. Father Name: ___________________
3. Present /Postal Address (for correspondence) ____________
__________________
4. Permanent Address __________________
__________________
5. Date of Birth ______ 6. Domicile _____ _____
7. Contact l No (1) ______ 8. Contact
ontact No (2)______ _________
9. CNIC No. ______ 10. E--mail _____ _______________
11. Academic Qualification:
Board/ Year of Obtained Total Division/
S. No Degree/Certificate
University Passing Marks Marks Grade

12. Professional Qualification/ Training/ Certification/ Others if any

any:
Diploma or
Name of Type of training/ Duration
S. No Certificate obtained
Institution/Board
/Board course
From To

13. Employment Record:

Nature of job
Name of institution/
S. No. Duration Designation BPS permanent/
Organization
temporary

It is hereby certified that information given in this application form is correct and nothing relevant has
been concealed.

Date: / /201
/2019.

Signature of Applicant