ONLINE APPLICATION FORM FOR
SPECIALIST- MONITORING AND EVALUATION (M&E) for India Health Action Trust (IHAT), Lucknow, Uttar Pradesh.

Position Code: SME-IHAT Location:Lucknow, Uttar Pradesh

1. Personal Details:

Applicant's Name:
Father/Husband's Name: Date of Birth:
Gender: Mobile No.:
Email ID: Alternate Contact No.:

2. Address:

Current City of Residence: City of Domicile(State):
Correspondence/ Current Address with Pin Code: Permanent Address with Pin Code

3. Qualification Details:

Name of the Degree/Diploma
Specialization & Principal Subjects
Name of University/ Institute (City)
Passing Year
Marks (in %)

4. Employment Details. (Please start with current/ most recent experience. If you have worked in more than one area/ post within the same organization, please enter details of the same separately):

# Name of Organisation Designation/ Title Key Responsibilities From To Location (City, State)
1.

5. Areas of Specialisation. (Please note that your response to this part of the application form shall be scored and qualitatively assessed to confirm your suitability for the post. We accordingly urge you to carefully fill your response and provide adequate details.):

# Name of Organisation Details of Job Responsibilities, Tasks, Accomplishments, etc. to Demonstrate Specialisation Duration of Experience (in months) Location (City, State)
 
1. Three years of professional working experience in M&E activities including but not limited to collecting and analysing data, developing project indicators and supporting performance monitoring and reporting.. (Please fill details of your experience in the row below):

6. Details of Compensation (Rs):

1. Current Annual CTC (Rs.)

7. Computer Skills:

(1) Experience of working on Data Portals:
(2) Understanding of Meta Data Structure:
(3) Proficiency in use of advance statistical method to conduct GIS based analysis using Q-GIS

(4) Proficiency in use of MS-Office
a. Excel
b. Word
c. Powerpoint

8. Language Proficiency:

Language Read Write Speak
English
Hindi
Confirm Ability to Travel as per Job Requirement. (Please refer to Vacancy Announcement): Joining Time (in days):

9. Upload CV:

Certification: I certify that to the best of my knowledge and belief, the details submitted by me correctly describe my qualification, experience and other information, as requested by SAMS.