Technical Support Volunteer Form
Personal Details
Your Name
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Gender
Female
Male
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Age
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Address
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City / Town
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District
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Alappuzha
Ernakulam
Idukki
Kannur
Kasaragod
Kollam
Kottayam
Kozhikode
Malappuram
Palakkad
Pathanamthitta
Thiruvananthapuram
Thrissur
Wayanad
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
Submit