National Instructional Media Institute
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EXPERTS REGISTRATION FORM
Name
Father / Husband's Name
Date of Birth
Gender*
Male
Female
Transgender
Contact Details of the Applicant
Address Line 1
Address Line 2
City / Town
Pincode
(Enter only numeric 6 digit)
District
State
Email Address
Phone
Mobile No
Aadhaar Number
(If available)
Qualification and Experience
Qualification*
Diploma
NCVT
UG
PG
PhD
Specify
Languages
Teaching Experience Details
Material Development Experience Details
Translation Experience Details
Subject(s) / Trade(s) of specialization / handling
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Trades Info
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Work Details
Category*
Government
Government Retired
Private
Private Retired
Working / Last worked Organisation Name
Organisation Address
Designation
Field of Specialisation
Already worked with / in NIMI ?*
Yes
No
If Yes, Specify your work details
Specify your period of association with NIMI
(Years/Months)
System Knowledge
Computer Working Knowledge
Yes
No
Typing knowledge
Yes
No
Bank Details
Name as in Bank Account
Account Type
Account Number
Bank and Branch
Bank IFSC Code
PAN Number of Applicant
I Accept to follow the norms and procedures for the media development at NIMI
