Application for Enlistment of Experts for Dam Safety Review Panels


*Required Fields
Application Category (As per ToR)*:






General information

Name of the Applicant*: Sex*:
Nationality*: Contact Address*:
Phone/Mobile*: Email*:
Date of Birth*: Upload Proof*:
Employment Status*:

Educational, professional qualifications, and trainings (Upload documentary proof)

Education
Degree University / College Year of Passing Discipline Document
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Training Programmes Attended
Subject Area of Training Organization Place Period / Duration
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Membership of National and International Professional Bodies / Organizations
Name of Professional Body / Organization Place Membership Category
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Technical Papers Published in National / International Events / Journals
Title of Papers Name of Event / Journal Year of Publication
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Association in the Publication of Dam Safety Guidelines / Manuals
Title of Guideline / Manual Nature of Association Year of Publication
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Affiliations Relevant to Dam Safety Management
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Language skills (ability to)
Language Speak Read / Write
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Employment Information and Professional Experience till date (provide latest first)
Employment Information: (Provide information in the following order: Job title, Employer, Dates (from - to), Responsibilities, highlight the work undertaken that best illustrates capability to handle the tasks assigned).(Upload relevant documentary proof)
1 Job title:
Employer:
Date: To
Responsibilities:
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2 Job title:
Employer:
Date: To
Responsibilities:
Upload relevant documentary proof:
3 Job title:
Employer:
Date: To
Responsibilities:
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4 Job title:
Employer:
Date: To
Responsibilities:
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Detailed Experience (Upload relevant documentary proof)
Total number of years of Relevant Experience (Total for all categories)*:
Details of dam failure investigations, if any:
Details of Experience in the rehabilitation of old dam structures:
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Other professional achievements such as any awards, special skills, etc:
Any other relevant information (Upload relevant documentary proof):
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Upload your recent photograph (Upload jpg, jpeg, png, gif file only):

Two known References:
1 Name:
Address:
Contact No:
Email Address:
2 Name:
Address:
Contact No:
Email Address:

Download Declaration Form Signed copy of this form is required to upload.

Health Declaration: I, the undersigned, hereby declare that I am of good health and able to travel as and when required during the assignment and fit for physical inspection of dam and its components. I further declare that I will perform all my inspection activities independently or in group together as per requirement.

Confidentiality Declaration: I, the undersigned, hereby declare that I am of good health and able to travel as and when required during the assignment and fit for physical inspection of dam and its components. I further declare that I will perform all my inspection activities independently or in group together as per requirement.

Certification: I, the undersigned, certify that to the best of my knowledge and belief, the information provided in the application correctly describes me, my qualifications, and my experience. I understand that any willful misstatement described herein may lead to my disqualification or dismissal, if engaged.

Date Full Name Signature

I certify the correctness of the information provided and agree with the above declarations.

Upload signed scanned declaration (Upload jpg, jpeg, png, pdf file only)*:

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