Shaukat Khanum Memorial Cancer Hospital & Research Centre

SKMCH-HRD-017

Volunteer/Non Professional Registration Form

Name:

Paste Photo Here

Father Name

Date of Birth:

National ID Card #:

Telephone (Res.):

Mobile / Cell:

E-mail:

Address:

Person to be contacted in case of emergency:

Relationship: Telephone #:

Qualifications:

Institution Degree Major Subjects Grade Year

Skills :

Professional/Internship Experience (if any):

Organization Job Title Dates Reason for

leaving From To

Shaukat Khanum Memorial Cancer Hospital & Research Centre

SKMCH-HRD-017

Availability:

Dates: From: To:

Are there any specific days or time that you are available? If so, please tick in appropriate box:

Mon Tue Wed Thu Fri

9 am 1 pm

1 pm 5 pm

Is there any specific department/area you are interested in? Please specify:

Referees:

1 Name: Telephone: Relationship

2 Name: Telephone: Relationship

I understand that volunteering for SKMCH&RC does not automatically entitle me for a permanent job.

Signature: _________________________ Date: ____________________

Instructions:

Attach one copy of National ID card

Students who are under 18 years are required to attach copy of National ID card of their parents

Attach one passport size photograph

Internship/Volunteership request letter from institution (if applicable).

Applications should be submitted at least three weeks prior to the proposed starting date.

Please send duly filled application to the address given below:

Human Resources Department

Shaukat Khanum Memorial Cancer Hospital and Research Centre

7-A, Block R-3, Johar Town, Lahore, Pakistan

Telephone: 042-35905000 Ext: 3040, 3041, 3037

or email at: careers@shaukatkhanum.org.pk

For Concerned Department Use Only:

Department Name: Signature:

Date of Joining: Availability Till:

For HRD Use Only:

Signature: Date

Application accepted: Yes No

Comments (if any):

Shaukat Khanum Memorial Cancer Hospital & Research Centre

SKMCH-HRD-017

TERMS AND CONDITIONS FOR VOLUNTEERS/INTERNS

I shall take care of my own belongings and valuables, SKMCH&RC shall not be responsible for

any loss or damage.

I shall indemnify any loss or damage caused by me to hospital property.

I shall abide by the rules and regulation (if applicable) and disciplinary policies and procedures at

SKMCH&RC.

I shall adhere to the timings that will apply during the volunteership/internship.

If I remain absent for more than two consecutive days without informing my supervisor my

volunteership/internship will be terminated.

Incase of any misconduct or in-disciplined behavior, SKMCH & RC reserves the right to

terminate the volunteership/internship at any time without assigning any reason thereof.

SKMCH & RC shall not be held responsible for loss or damage caused to me by any natural

causes.

I shall not, during the continuance or after the termination of your volunteership/internship,

disclose any information obtained or acquired concerning the affairs of the Hospital unless

compelled to do so by a Court of Law. If I disclose any such information, the Hospital reserves

the right to take legal action against me.

During my stay, SKMCH & RC shall not provide any medical coverage or transport facility.

Certificate of volunteership/internship will be given to those candidates who will complete their

volunteership/internship satisfactorily.

No stipend will be paid to the volunteers/interns.

I, ________________, hereby accept and agree to abide by the terms and conditions mentioned

here-in-above.

Signature: Date:

Witnesses:

1.

2.