FACULTY REGISTRATION/
RENEWAL
FORM
Photo
Three photographs I X I inch
PM&DC Registration
Name:
Title:
Permanent Address:
No.
Email:
Postal Address:
Phone:
Fax:
Email:
Phone:
College/University Name:
Department:
Registered Qualifications:
PM&DC Registration No.
D Faculty Contract
Classification
n Faculty Regular
Rank
Full Time
Job Status
Fax:
Effective Date of
Contract
Part Time
I fully understand that I am being registered as faculty, under the Part-XII of the Pakistan
Registration of Medical & Dental Practitioners Registrations, 2008, which I have read
and fully understood. I have been also fully understood that any violation of these rules
shall make me liable for action and may have penal consequences.
Signature of Applicant.
Date.
Signature & Seal of Principal/Dean
of Institution
------------------------------------------------------(For Office usc only)
Faculty No.
Assistant
_
Superintendent
Date
Assistant/Deputy
Registrar