1. Healthcare

MEGFIAI,AYA BASIN DEVELOPMENT AUTHORITY
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Pk 03 64 -25ZZe Z /
(IUBDA)
HQR:SI{LLONG
Fax,0364-252292I
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Email: mbmashillong@ gmailcom
PRESCRTBED APPUCATION FORM FOR APPLYING FOR RECRUITMENT TO MBDA
I.
Name of t'he Candidate:
Paste recent
passport size
2.
Complete Address:
3.
Date of Birth and Age as on 0I.0L2OI5i
4.
Name of the post being applied for:
Name of post
Sl no
Location
I
Sr. Manaoer fTreinino)
2\
Manaser (Trainins)
Sr. Manaser (Enterprise Development & EFC Coordinator)
Manager (Enterprise Development & EFC Coordinator)
Sr. Manaser (Monitorinq & Evaluation & Planninq)
Manaoet (Monitorino & Evahration & Plannins)
District proiect M: na ser
J
4)
s)
6)
7\
9)
St. Manaser (Knowledoe Manasement)
Assistant Manaoer (Field Monitodno)
r0)
Assistant Manaoer (Data Analvsis)
II
Assistant Manaser (Finencial Analvsis)
r2)
r3)
Assistant Manaser/Prosrarnme Associate (MIS)
8)
5.
photograph
Tick only one
Executive Assodate
Employment Recor& (Staarng with Current/Last e-plopnent)
Name oftheOrganiation
v
Period ofEmployment
Fronr:
Designation
To:
,/
t,
Naurre of work
6.
Pre- requisite qualfications for tlre
Examination Passed
7.
posu (Starting with Latest/Last qualification with supporting
Year
Name ofthe
Collqe/Univesrty
documents to be endosed)
f1o oflv{ark
Division
E';
Any Other qualifications:(rncluding Training colrses amended, Diplomas, Softwate courses, etc)
Course Attended
Name of the Insdnrtion
Duratior{Fromrnmr/ry 1 o
Crade/Division
mm/w
8.
Relevaat Experience for the post being applied for:
9.
Ad&esses for Corrrrrnmication:
I0.
E-mail:
II.
I2
Mobile:
Tdephone:
Declatation:
I
any
hereby dedare
tlat
tlre information firrnished above is tflre to the best of my knowledge.
I
information is.found to be false/misleading, I rnay be liable to be disquali&ed from the recnritnrent process.
I i,*
Date:
,/
,r',
Signature of candidate:
t,
rmderstand that
if