Thank you for your interest in Wipro. This form is intended to enable you to record important points about yourself, your experience, your achievements and your plans for the future. Please complete the form in full and use additional sheets if necessary. When we meet you at the interview, the contents of this application will provide a base for our interaction.



X) Course/Degree Specialization Name of Institute /University Address Graduatio n (Month/Yr.PERSONAL INFORMATION First Name Mr/Ms ( Expand all names) Date of Birth d d m m y y Current Address : City Permanent Address : City State PIN Phone(with STD code) Mobile y Y e-mail : Middle Name Last Name Kindly affix a Passport size Photograph Her State PIN Phone (with STD code) Offic e Res. EDUCATION (Begin with the most recent qualification and end with Std. EMAIL ID & Contact Number Can we take reference from your supervisor? Yes No  Deputation Details :( Mention name through current of organization to whom you were deputed employer Please mention NA if not applicable) WWW. ) Aggregate Marks (% or CGPA) TRAINING Training/Development Programmers attended / IT Skills acquired Institute / Organization Location Dates attended From To WORK EXPERIENCE Number of Companies Worked for (Count should include the Present Employer) CURRENT EMPLOYMENT Name of the Employer Number of Employees Date Employed Your Designation & Department From Employee Code Responsibilities Sales Turnover To Address : Phone : Notice Period : Reason For Leaving Supervisor’s Name & Designation.COM 2 .WIPRO.

Please mention NA if not applicable) ALL OTHER PREVIOUS EMPLOYMENT DETAILS Name of the organization Location Designatio n Employe e Code Duration From To Monthly Salary Starting Final Reason for Leaving ABOUT YOURSELF The answers to the following questions will help us get a better understanding of you as a person.WIPRO. sports. of stocks} Address : TO Phone : Total (A) Do you have employee stock options? No  PREVIOUS EMPLOYMENT Name of the Employer Dates Employed FROM  Yes Your Designation & Department Employee Code Responsibilities Reason For Leaving Supervisor’s Name & Designation. EMAIL ID & Contact Number Monthly Gross: - Deputation Details :( Mention name of organization to which you were deputed through current employer. Name Duration & Organization & Designation e-mail Phone (with STD code) Nature of Home Office Association WWW. Nett gain at current value : {(Current Market Price – Issue price) x No. Honors. Pension. (C) Company car Furnishings Others (please specify) Total (B) Monthly Gross (A+B+C) Current Annual Gross Expected Annual Gross If yes. Gratuity etc. Awards ( Academic/extra curricular ) received OTHER INTERESTS: Cultural. Your personal strengths? Your personal areas of improvement? Your career objectives? Your expectations from the job/Wipro? SIGNIFICANT ACHIEVEMENTS: Distinctions.MONTHLY EMOLUMENTS Fixed Salary Basic Bonus/Incentives Allowances Others (please specify) Housing Variable / Perks Deferred benefits PF. community work and hobbies from school onwards & details of memberships of association REFERENCES Give references under whom you have either worked or who know you professionally for at least 6 months.COM 3 .

other than minor traffic offenses ? Yes No In the last ten years. furnish details including type of offense and conviction Yes ( ) NO ( ) Yes ( ) NO ( ) Yes Do you have any commitment to another employer or organization that might affect your employment with us? No Any other information you would like us to know which may have significant bearing on our hiring decision : WORK LOCATIONS Are you willing to be posted anywhere in India? No Indicate your preferred work location in India Yes Are you willing to be posted abroad? Yes No DECLARATIONS 1.Off: Per: Off: Per: Off: Per: ADDITIONAL DETAILS If Others. Division : Month/Year: If Yes.COM 4 . I authorize all persons who may have information relevant to the verification to make disclosures to Wipro or its representatives/ agents. I hereby declare that my statements on this form and on my resume or documents provided by me to Wipro are true and correct to the best of my knowledge. I understand that Wipro. I understand and agree that Wipro has rights to seek any legal remedies including indemnification and damages from me for any loss caused to Wipro as a result of any such false information.WIPRO. Wipro assures me that background check on my current employment will be taken up only post my joining Wipro and this is acceptable to me. have you been convicted of or plead guilty to any offence? In the last ten years have you been released from prison on a conviction? If Yes. at its discretion. Date: Signature: Place: Name: WWW. 5. In addition. Details Location : Status :  Yes Yes Yes Have you attended any selection process at Yes No Wipro before? Do you have any relative / friend employed With Wipro? Yes No Have you suffered from any major illness /surgery /accident in the last five years? Yes No Have you ever been arrested. Details If yes. his/her name : Division/Location : If Yes. 3. Passport No : Valid till : If Yes. I understand that Wipro may notify and publish any information provided by me that is found false. provide details on countries visited and type of Visas held If Yes. 2. may result in termination of my employment. prosecuted or convicted for any criminal offense. I acknowledge and agree that providing any false information may result in a decision not to hire me or if hired. Specify Nationality : Nationality Do you hold a valid Passport? No (for Indian citizens only) Have you been denied VISA to any country? No Have you worked on overseas assignments? No  Indian  Others Yes Do you have work permit to work in India?  No If Yes. may institute and conduct a background check to verify the information furnished by me in this form. 4.

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