Teacher Registration Page

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Personal Details

Faculty Name:

Email-ID:

Father's Name:

Mother's Name:

Religion:

Mobile/Primary contact number:

Mobile 2/Other Contact number:

Permanent Address:

City:

State:

Pin Code:

Aadhar No:

PAN No:

Bank Details

Salary Account

a. Bank A/c Number:

b. Bank Name:

c. Bank Branch:

d. IFSC Code:

Savings/Personal Account

a. Bank A/c Number:

b. Bank Name:

c. Bank Branch:

d. IFSC Code:

Professional Details

Designation:

Qualification:

Teaching Experience:

U.P. Registration Details (If Registered with U.P. Council)

Registration No.:

Registration Date:

U.P. Registration Applied Details (If Applied For Registration with U.P. Council)

Receipt No.:

Receipt Date:

Other Council Registration Details (If not Registered with U.P. Council)

Other Registration No.:

Other Registration Date:

Council Name:

Name of College:

College Address:

Previous Designation:

Faculty:

Specialization:

Clinical Experience:

Experience in UG:

Experience in PG:

Experience after M.Sc:

Experience after GNM:

Total Experience:

Note on Experience:

Nature of Appointment: Regular/PermanentPart-time/Contract

Appointment Date:

Confirmation Date:

Photo / Signature

Passport Photo (JPG/PNG file types only, < 200kb)

Signature (JPG/PNG file types only, < 100kb)

Pan card (JPG/PNG file types only, < 100kb)

Aadhar Card (JPG/PNG file types only, < 100kb)

Academic (JPG/PNG file types only, < 500kb each)

10th certificate

12th certificate

B.Sc Nursing marksheets (4)

BSc Marksheet 1:

BSc Marksheet 2:

BSc Marksheet 3:

BSc Marksheet 4:

B.Sc Nursing Degree

Experience certificate after GNM

Experience certificate after B.Sc Nursing (1)

Experience certificate after P.B.B.Sc Nursing

Experience certificate after M.Sc Nursing

Other Experience certificate

M.Sc. Nursing marksheets (2)

M.Sc. Nursing Degree Certificate (1)

GNM marksheet

GNM Diploma

Other

INC registration certificate

I submit that the above details are correct to the best of my knowledge and I bear all responsibility thereto, which is provided by me is true, and take all responsibility for the same.

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Teacher Registration Page

Salary Account

Savings/Personal Account

U.P. Registration Details (If Registered with U.P. Council)

U.P. Registration Applied Details (If Applied For Registration with U.P. Council)

Other Council Registration Details (If not Registered with U.P. Council)

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Nightingale Institute Of Nursing, Noida