Jordan Hospital CareersHomeResidency Application FormPlease enable JavaScript in your browser to complete this form.Residency Application FormPlease choose one specialty and submit one application only. In case of submission of more that one application the candidate will be disqualified Select DepartmentGeneral surgery residencyInternal medicine residencyRadiology residencyEar nose and throat residencyOBGYN residencyOrthopedic residencyAnesthesia residencyPediatric residencyNeurosurgery residencyName *FirstLastPhone No : *Second No: *Nationality *Address / Residence : *Date of Birth: *Place of Birth: *Marital Status: *MarriedSingleDivorced Present / Last Position ( Job Title) : *Years of relevant experience : *Qualification: *Position Applied for: *When will you able to start work: *Place of graduation: *Date graduation: *Education & Training QualificationIn chronological order,please detail all academic, professional, and training courses attended, whether full time or by correspondence courses:Certificate / Diploma or Degree Obtained (Place and Date)Upload the following documents Click or drag files to this area to upload. You can upload up to 10 files. Please enclose the following with your application: - Certified copies of relevant certificates. - Diplomas, University degree. - Copies of registration documents. - Current copy of work license. - one passport size photographs. - Passport/ ID photo.Proficiency in Languages Mother languages:Arabic: *English: *Other: *List any serious illness in the last 5 years and give details of any physical disability *Next of Kin:Name *FirstLastTel. No. *Address *Father's Full Name: *Mother's Full Name: *Applicant Declaration :I certify that all statements made herein are complete and correct, I understand that any omission or misrepresentation may lead to my dismissal from any position I may secure.Signature : *Date: *Submit
