REGISTRATION FOR KERALITES RETURNED FROM YEMEN / LIBYA / IRAQ
  [Non Resident Keralites returned from YEMEN, Libya and IRAQ are requested to register their details here. For any assistance please contact NORKA ROOTS Call Centre at 1800 425 3939]
       
  Country [You have returned from] *  
  Name as in Passport *  
  Surname  
  Given Name  
  Gender  
  Date of Birth [dd/mm/yyyy]  
  e-mail *    
  Mobile *    
  Passport Number *    
  Permanent Address with Pincode *    
  District *    
  APL / BPL    
  DETAILS OF LAST JOB IN Yemen / IRAQ / LIBYA
  Name of Hospital / Company    
        Dates:  From - To [dd/mm/yyyy]      
         Position held    
        Salary drawn in Foreign Currency    
        Salary drawn in Indian Currency    
  DETAILS OF PREVIOUS JOB EXPERIENCES - ABROAD
  Country Company Position held Works done Salary drawn Date From Date To
 
 
 
 
  WORK EXPERIENCE IN INDIA
  Serial Number Company Position held Works done Salary drawn Date From Date To
  1
  2
  3
  EDUCATIONAL QUALIFICATIONS    
  Serial Number Qualification Board/Council/ University Year of Passing Marks[%/Grade]    
  1    
  2    
  3    
  4    
  OTHER DETAILS    
  Total years of Experience abroad    
  Languages Known    
  Name of Father    
  Occupation of father    
  Name of Mother    
  Occupation of Mother    
  Married    
  Name of Spouse    
  Occupation of Spouse    
  Name of Village of your Residence    
  Date of Last Arrival in YEMEN/IRAQ/Libya    
  Date of Arrival in India, from YEMEN/IRAQ/Libya    
  Have Salary Arrears from the last employer    
                  If Yes, then Amount    
  Tickets obtained through    
  Flight Number    
  Your Future Plan / Preferred Place for Re-employment    
  Preference of Place for Future Job    
  Preference    
  Any other details you want to communicate to    
  If you are working in the Nursing profession, please submit the following also    
  Nursing Qualification    
  Any Other Qualifications, if any.    
Whether requires training for MOH Exams