7. Professional qualifica- tions and the date at which each was obtain-
ed.
M.B.ChB (Edin) 1901
8. Any military experience Chinke Base Hospital, Noyelles
you have had
Jul-Dec., 1917
Dec. 1917 M.O. Fist Western Sen. Hosp. Liverpool
be stated here, with a MO., Chinese, Janks Corps, HQ.,
-July 1918. Oct 1918-Jan 1919.
note of any certificates, etc., obtained.
9. Mention any prizes, scholarships, or other distinctions gained during your general or professional education or subsequently; also any contributions. to medical literature.
State here any knowledge Passed camin Cantonese, 1903
you possess of any language
other than English.
10. Mention any clinical
appointments held-
Non-resident
Resident
Give the date and duration
of each appointment.
11. State how you
have
been engaged since
you obtained a qualifi-
cation...
Mention each position held
by you, the dates between
cause of leaving,
Surgeon, Church Inission, Pakhoi
Leper's General Hospital) Jan. 1902-July 1903 deft on health grounds) Private Practice, Cumberland 1904-1906 Left to return to China)
a
Sphere)
1906
which you held it, and the medical Mission, Kweilin, Mar. 1906- nov., Medical Mission Nanning Reg. 1406 Dec. 1916 Left on account of wife health)
(Information given under 8 should not be repeated).
12. If you apply for a
particular appointment state it
If you do not apply for a particular appointment, state to what Colonies you would go, giving the order of preference.
(Before filling in these parti- culars you should read care- fully the papers headed Miscellaneous No. 99 and African (West) No. 678.)
Feb. 1919-Feb 1924
Hong Kong Colonial
Medical
Lica Service
Fee
13. Give particulars of any physical impairment from which you may have suffered (includ- ing shell-shock, nerve strain, etc.).
14. About how soon would you be available to proceed overseas if selected.
15. Personal References.
They
Give the names and addresses
of two referees. should be responsible per- sons who know you well, either in private life or in business; and one at least should be well acquainted with you in private life. The names of distinguished persons should not be given unless they really" "know you well; and the names of relatives or of those from whom you send testimon- ials should not be given.
16. Testimonials.
412
1. Name Rt. Rev. Bishop Banister
Address
Kuling,
China Missionary biodop retired
Occupation Period during which he has known you
1902
1906
Name Lt. Col. 7. 8. Fikserald Address 463 Peak, Hong Kong
Occupation S. M. O., China Command
Period during which
he has known you 1923–24
You should submit not more than six testimonials, to cover as far as possible your education and each subsequent stage of your career. The original testimonials and one copy of each should be sent. The former will be returned after inspection. Copies may be in MS., in print, or typewritten; and it is desirable that they should be on foolscap paper not larger than this form,
You should give the name, address, and occupation of the writer of each of your testimonials; the period of your cureor for which he can speak and the capacity in which he speaks, e.g., (Col. A.B., my C.O., January, 1915-- March, 1918).
Should the writer of a testimonial prefer to send it direct to the Assistant Private Secretary (Appointments), there is
no objection, but in such a case you should state hereon that he is doing so.
The names, etc., of other persons to whom reference can be made may be added if desired. If, for any reason, you experience difficulty in obtaining a testimonial to cover a particular period of your career, you should state the reason in writing. In this case the name and last known address of someone who would be in a position to report on your character and conduct during the period in question should be given.
It is desirable, but not essential, that one of your testimonials should be from the Dean of the Medical School at which
you were educated,
{TURN OVER.
No comments yet.
Private notes are available after approval.