Technical Support Volunteer form

Personal Details

Your Name

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Gender

Female

Male

Prefer not to say

Age

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Address

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City / Town

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District

Please select a valid district.

Phone Number

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Email ID

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Qualifications & Experiences

Heighest Degree of Qualifications

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Field of Engineering
Please state the Engineering Field

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Degree / Diploma received in the year

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Organization Affiliation

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Area of Expertise

Have Experience in Medical Equipment

Have Experience in Sub Stations and Generators

Have Experience in Electrical Maintenance

Have Experience in Mechanical Engineering Work

Have No Experience in any of the above but willing to learn

Other

You are willing to share the above details with the Hospital Staff and Authorities. This may be handed over to the Hospitals and Government and their privacy rules may apply.

I Agree to the Privacy Statement Above

I know the dangers of volunteering. I may have to work in Hospitals along with the Medical Staff and the dangers of the virus. I will also always protect myself from harm in every way possible. I will not hold responsible IEEE Kerala Section, its constituents for any consequences.
I have also not been forced by anyone to register here and I am doing so out of my free will.

I accept the above statement, "risk clause" and the "free will" clause