Please

Affix
Your
Passport
Photo Here

INFOSYS TECHNOLOGIES LIMITED
Electronics City, Hosur Road, Bangalore - 560 100, India.
Tel.: (080) 28520261-270. Fax: (080) 28520362.

APPLICATION FOR EMPLOYMENT
01. Please answer each column fully and neatly in your own handwriting.
02. Please ü in the

wherever applicable.

Interview Location................................................................

PERSONAL DETAILS

NAME IN FULL
(in block letters)

................................................................................................................................................................................
FIRST
MIDDLE
SURNAME

PERMANENT ADDRESS

ADDRESS FOR COMMUNICATION

.......................................................................................................

..................................................................................................

..................................................................................................

..................................................................................................

..................................................................................................

..................................................................................................

..................................................................................................

Day Time Contact No. ..................................................... (Optional)

..................................................................................................

Mobile No. ................................................................................

Tel. No. (Specify area code)....................................................................

e-mail: ......................................................................................

DATE OF BIRTH :
(dd/mm/yyyy)

AGE :

PLACE OF BIRTH :

..........................................

..................

DOMICILE OF (STATE IN INDIA) :

CITY : ..........................................
COUNTRY : ..................................

.............................................................

CITIZENSHIP(S) :
SEX :

MALE

FEMALE

...............................................................................................

FAMILY
PARTICULARS

RELATIONSHIP

OCCUPATION

NAME

ADDRESS

FATHER/
GUARDIAN
MOTHER
SPOUSE
ALLERGIES, IF ANY ...............................................................................................

BLOOD GROUP :

HEALTH

....................................

.................................................................................................................................
LAST MAJOR ILLNESS/SURGERY
(Specify Date)

VISION :

LEFT

RIGHT

..............................................................................................................
...............................................................................................................
....................................................................................................................

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PASSPORT DETAILS

DO YOU HAVE A PASSPORT?

YES

IF YES, PLEASE FILL IN THE PARTICULARS

NO

PASSPORT NO. :

DATE OF ISSUE :

VALID UPTO :

ISSUED BY :

PLACE :

........................................

........................................

........................................

........................................

........................................

ADDRESS IN PASSPORT :

EMIGRATION CHECK REQD. :

YES

NO

....................................................................................................
......................................................................................................

IN CASE YOU HAVE ONLY APPLIED FOR PASSPORT,

..............................................................................................

DATE OF APPLICATION : ..................................................

..............................................................................................

TO WHOM : ......................................................................

LEVEL**

X STD*

XII STD/DIP./EQUIV.*

POST
GRADUATION*

GRADUATION*

OTHERS*

NAME OF THE
QUALIFICATION AWARDED
BOARD /
UNIVERSITY
SCHOOL /
COLLEGE
AREA OF
SPECIALIZATION

EDUCATION

YEAR & MONTH OF
FINAL EXAMINATION
TOTAL AGGREGATE
MARKS SCORED FOR ALL
SUBJECTS / SEMESTERS /
YEARS
MAX. MARKS FOR ALL
SUBJECTS / SEMESTERS /
YEARS
SIMPLE AVERAGE
PERCENTAGE / CGPA /
GRADE FOR ALL YOUR
SUBJECTS / SEMESTERS
POSITION/RANK IN
THE CLASS
*ALL PERCENTAGES / CGPA SHOULD BE SIMPLE AVERAGE FOR ALL YOUR SUBJECTS / SEMESTERS / YEARS.
**ALL INFORMATION PROVIDED WOULD BE VALIDATED AT THE TIME OF JOINING, IF AN OFFER IS MADE.

GAPS IN EDUCATION (If any) ..................................................................................................................................................
SCHOLASTIC ACHIEVEMENTS (Ranks, Merit Scholarships, Prizes, etc.) ..............................................................................
..............................................................................................................................................................................................................................
..............................................................................................................................................................................................................................
EXTRA CURRICULAR ACTIVITIES...........................................................................................................................................
.........................................................................................................................................................................................................
.........................................................................................................................................................................................................

LANGUAGES

MOTHER TONGUE : .................................................
LANGUAGE (Please highlight foreign languages)

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PROFICIENCY
Can
Understand

2 of 5

Can
Speak

Can
Read

Can
Write

HRD/REC/E/011

PLEASE WRITE ‘NA’ IF NOT APPLICABLE.
Specify clearly in case of part time/contract work experience.
ORGANIZATION

PERIOD (MM/YYYY)
TO

DESIGNATION

DURATION
(in months)

MAJOR
RESPONSIBILITIES

REASON FOR
SEPARATION

TECH. SKILLS PROFILE

(For Software Professionals)

WORK EXPERIENCE

FROM

Notice period required.......................................

HARDWARE PLATFORMS WORKED ON :
...........................................................................................................................

OPERATING SYSTEMS / DATABASES USED :
....................................................................................................................

LANGUAGES & TOOLS FAMILIAR WITH :
..........................................................................................................................
LIST THREE PROFESSIONAL REFERENCES (not related)
SL. NO.

NAME & ADDRESS

OCCUPATION

EMAIL

TEL. NO.

REFERENCES

01.

02.

03.

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DO YOU KNOW ANYONE WORKING AT INFOSYS PRESENTLY?

YES

NO

IF YES, PLEASE LIST THEM BELOW

REFERENCES

NAME

RELATIONSHIP

DESIGNATION

..........................................................................................................................................................................................................

CONTACT PERSON IN CASE OF EMERGENCY :
NAME & ADDRESS

COMPENSATION**

TEL. NO. (EVEN P. P.)

NEXT REVISION EXPECTED
IN YOUR PRESENT JOB
DATE:................................

CURRENT

RELATIONSHIP

YOUR EXPECTATION AT
INFOSYS

1. MONTHLY
Basic .......................................................................................................................................................................................
HRA .........................................................................................................................................................................................
Dearness Allowance ...............................................................................................................................................................
Conveyance Allowance/
Reimbursement ........................................................................................................................................................................

COMPENSATION

Professional Journals ..............................................................................................................................................................
Education Allowance ..............................................................................................................................................................
Other Monthly Allowance ........................................................................................................................................................
SUB TOTAL (A)
2. ANNUAL
LTA ..........................................................................................................................................................................................
Medical Reimbursement ...........................................................................................................................................................
Bonus/Ex-gratia .......................................................................................................................................................................
Other Annual Benefits .............................................................................................................................................................
SUB TOTAL (B)
3. RETIREMENT BENEFITS
Provident Fund ........................................................................................................................................................................
Gratuity ...................................................................................................................................................................................
Superannuation .......................................................................................................................................................................
SUB TOTAL (C)
GRAND TOTAL (A+B+C)
Amount Eligible

BENEFITS

LOANS :

% Interest

ESOP’s : Numbers
Issue Price

Housing
4 Wheeler

Others :

Other
**ALL INFORMATION PROVIDED WOULD BE VALIDATED AT THE TIME OF JOINING, IF AN OFFER IS MADE.

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HAVE YOU UNDERGONE ANY SELECTION PROCESS WITH INFOSYS OR INFOSYS GROUP
COMPANIES (LIKE PROGEON, ETC.) PREVIOUSLY ?
IF YES, HAVE YOU

INFOSYS

NO

OTHER GROUP COMPANIES
RELEVANT DATES

- TAKEN ANY TEST ?

NO

YES

- BEEN SELECTED FOR INTERVIEW ? NO

YES

- BEEN MADE AN OFFER ?

YES

NO

ARE YOU EMPLOYED AS :

YES

RELEVANT DATES

.........................

NO

YES

.........................

.........................

NO

YES

.........................

.........................

NO

YES

.........................

A. A DIRECTOR IN ANY OTHER COMPANY?

NO

YES

B. A PARTNER IN ANY FIRM ?

NO

YES

MISCELLANEOUS

IF YES, PLEASE MENTION DETAILS OF THE SAME :...................................................................................................................
................................................................................................................................................................................................................
ARE YOU UNDER ANY LEGAL OBLIGATION TO YOUR CURRENT EMPLOYER?

YES

NO

IF YES, PLEASE CLARIFY :........................................................................................................................................................
...................................................................................................................................................................................................
ARE YOU CURRENTLY EMPLOYED WITH ANY OF THE INFOSYS GROUP COMPANIES ?
IF YES,

PROGEON

OTHERS

Please Specify .......................................................................................

Have you at any time been convicted by a court of India for any criminal offence and sentenced to imprisonment, or any criminal proceedings are pending against you before a court
in India, or an order prohibiting your departure from India has been issued by a court,

YES

NO

If yes, please give details of the same...................................................................................................................................................
.........................................................................................................................................................................................................
.........................................................................................................................................................................................................
DECLARATION
I certify that the above statements made by me are true, complete and correct. All the academic marks / percentages / CGPA
are simple average for all subjects / semesters / years. I agree that in case the company finds at any time that the information
given by me in this form is not correct, true or complete, the company will have the right to withdraw my letter of appointment
or to terminate my appointment at any time without notice or compensation.
Place : .......................................
Signature: ..............................................................

Date : .........................................

Date of Test :......................... Date of Interview :............................

FOR OFFICE USE ONLY

Score :.......................... Written Test Ref. No. :...............................

LOCATION PREFERENCE
1) ...........................................................................

Panel & Employee No. :...................................................................

2) ...........................................................................

.......................................................................................................

3) ...........................................................................

Result : Selected

Hold

Rejected

(Please ü )

Role :................Personal Band (if any) :.......................Job Band :.................. Location : ......................................................
Proposed Basic :............................

Likely Joining Date : ........................
(MM/YYYY)

Training Requirement :
Duration of Training :

Special Allowance : ........................

YES

NO

..................................

Reason for Selection/Rejection : ..................................................................................................................................................
..........................................................................................................................................................................................................
..........................................................................................................................................................................................................
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