KHYBER COLLEGE OF DENTISTRY
PESHAWAR
MEDICAL TEACHING INSTITUTION
Job Application Form
ATTACH
• Attested photocopy of CNIC.
• 2 attested (passport size) photographs. Attach
• Attested Photocopies of all necessary documents like Degree,
Certificates, Experience Certificate, Domicile, License 2 x Passport
• Original Bank Draft / Deposit slip Size
Photographs
(To be filled in CAPITAL letters)
Post Applied for
Bank Draft/Deposit Slip No: Date:
Bank Name & Branch:
1. Applicant's Name:
2. Father/Husband Name:
3. Date of Birth: 4. Domicile:
(dd / mm / yyyy) (Distt. /Agency name)
5. Nationality: 6. CNIC / Passport No.:
7. Religion: 8. Blood Group:
9. Contact No. (Primary): 10. Contact No.(Secondary):
11. Email address:
10. Permanent Home Address:
11. Mailing Address:
12. Next of Kin (Name):
Relation: Contact Details:
Address:
13. EDUCATIONAL QUALIFICATION (Starting from the recent one):
Degree /Diploma/ Name of Institution / Marks
S# Date of Issuance Grade/Div/CGPA
Certificate University / Board (Obtained/Total)
1|Page Applicant's Signature:______________________
KHYBER COLLEGE OF DENTISTRY
PESHAWAR
MEDICAL TEACHING INSTITUTION
Job Application Form
14. PROFESSIONAL COURSES / TRAINING etc. (If any):
S# Course/Training Title Institute Name From Date To Date Duration
1
15. RESEARCH
S# Title DATE JOURNAL NAME AUTHORSHIP
1
10
16. Professional Registration / Licenses (PMC, PNC, CPSP, PEC etc.)
S# Professional Body Number Issue Date Expiry Date
2
17. EXPERIENCE (Starting from Recent/current job):
Name of Total Reason for
S# Designation/ Post From Date To Date
Organization Experience Leaving
Applicant's Signature:______________________
2|Page
KHYBER COLLEGE OF DENTISTRY
PESHAWAR
MEDICAL TEACHING INSTITUTION
Job Application Form
18. LANGUAGES:
S# Language Read Write Speak
1
2
3
19. Give Three Referee Names (Only Professional or Educational References are required):
Name: Name:
Designation: Designation:
Relationship: Relationship:
No. of Years of Acquaintance: No. of Years of Acquaintance:
Contact No. Contact No.
Email Address: Email Address:
Name:
Designation:
Relationship:
No. of Years of Acquaintance:
Contact No.
Email Address:
20. Disability (If any): [Please (√) the box] Yes No
If Yes, Please specify:
21. Depression/Psychiatric Problem (If any): [Please (√) the box] Yes No
If Yes, Please specify:
22. Do you have any criminal record? [Please (√) the box] Yes No
If Yes, Please specify:
23. Drug addiction (Heroin, Cocaine, Ice etc): [Please (√) the box] Yes No
Applicant's Signature:______________________
3|Page
KHYBER COLLEGE OF DENTISTRY
PESHAWAR
MEDICAL TEACHING INSTITUTION
Job Application Form
24. Checklist of required documents attached
Attached Not Applicable Page No.
S# Name of Document (Please tick if attached) Please Tick if not applicable
(Write page number on the top right corner of the
attached documents)
1 CNIC
2 Domicile Certificate
3 Matric Certificate
4 Matric DMC
5 Intermediate Certificate
6 Intermediate DMC
7 Bachelors/Graduation Degree
Bachelors/Graduation
8
DMC/Transcript
9 Master Degree
10 Master Degree DMC/ Transcript
11 M. Phil /MS Degree
12 MPhil/MS DMC /Transcript
13 PhD Degree
14 Post Doctorate Certificate
15 Relevant Experience Certificate
• Attached Additional Sheet (if required)
25. Applicant's Declaration: I, Mr./Ms , hereby solemnly affirm that
the information given above are true, correct and that nothing has been concealed. If any information were proven to
be untrue/ concealed, I will be liable to punishment in the form of termination/cancellation of appointment and further
disciplinary actions.
Note:
• Job Applications, duly filled, are only accepted against the advertised posts.
• Incomplete Applications are not acceptable.
• Job Application submitted after closing date, will not be entertained
• Candidates will be contacted through given contact numbers or email.
• Only Shortlisted Candidates will be contacted for Test/interview.
• Kindly bring your original documents at the time of interview.
• If any fields isirrelevant, mark as N/A.
Applicant's Signature:______________________
4|Page
