EMPLOYMENT

FORM

NOTES

This form should be completed in own handwriting by the candidate.

This form is intended to ensure a fair assessment of education, experience
and trainings attended.
Please use the sheets for additional information to amplify any item you
consider needs full explanation.
Recent passport size photograph should be enclosed.

Space for
Photograph

POST APPLIED FOR

1.

Personal Particulars:

First Name: Mr/Mrs/Miss ___________________ Middle Name: ___________________ Surname: ___________________

(CAPITAL LETTERS)
Permanent Address:
__________________________________________________________________________________________________
___________________________________________________________________ PIN Code: ______________________
Present Address:
__________________________________________________________________________________________________
___________________________________________________________________ PIN Code: ______________________
Contact: Resi: _______________ Office: _________________ Mobile: _________________ Email: __________________
Date of Birth: __________________

Place of Birth: _______________

Gender: Male/Female

Nationality: ___________________ Blood Group: ______________ Height: __________ cms. Weight: _________ kgs.
PAN No: ______________________ Passport No.: ___________________ Marital Status: Yes / No. ________________
(If yes, date of Marriage)
Mark of: __________________________ Residing At: ________________ Do you own a vehicle: __________________
Identification
(Own / Rented House)
(Two / Four Wheeler)
Aadhaar Card No: ____________________________
Details of Family: (including parents)
Name of Family Member

Date of Birth

Relationship

Occupation

Details of any serious illness, operation or accident

resulting in incapacitation for a month or longer: _________________________________________________________
Do you have any physical disability? If so, please state nature and degree: ____________________________________
Name & Address of person to be contacted in case of emergency: ___________________________________________
__________________________________ Relationship: _______________ Tel: No.: ___________________________
Are you a member of the Employee Provident Fund Scheme? If yes Account No.: _______________________________

2.

Languages Known: Indicate against each language whether fluent, fair or slight
Language

Speak

Read

Write

3.

Education: Begin with School Leaving Examination.

Degree / Diploma
Certificate

4.

Year of
Examination

Name of School / College and

University

Subject of Study
(Indicate specialized subject with an
asterisk*)

Working Experience: Begin with present employer, then previous

Period

From

Division /
Class

Name & Address of the employer

Designation

CTC p.a.

To

Job Description: In continuation to the above table

Reporting To

Products Handled /
Area of Work

Duties / Role Performed

Reason for Leaving

5.
Sr. No.

Details of the Salary Structure (with present employer)

Particulars
Designation

1.

BASIC

2.

FIXED DEARNESS ALLOWANCE

3.

VARIABLE DEARNESS ALLOWANCE

4.

HOUSE RENT ALLOWANCE

5.

CONVEYANCE ALLOWANCE

6.

EDUCATIONAL ALLOWANCE

7.

TELEPHONE ALLOWANCE

8.

ANY OTHER ALLOWANCE

TOTAL (1 to 8)
REIMBURSEMENT

i.

MEDICAL

ii.

LEAVE TRAVEL ASSISTANCE

iii.

DRESS ALLOWANCE

iv.

MEDICLAIM

v.

ESIC

vi.

ANY OTHER COMPENSATION

TOTAL (i to Vi)
INCENTIVES

a.

BONUS / EX-GRATIA

b.

INCENTIVE (VARIABLE & FIXED)

c.

a+b
RETIRAL BENEFIT

I.

PROVIDENT FUND

II.

GRATUITY

III.

SUPERANNUATION

TOTAL(I to III)
TOTAL CTC=(A + B+C + D)

OTHER BENEFITS

(1)

PERSONAL ACCIDENT INSURANCE

(2)

MEDICAL INSURANCE

(3)

CAR

(4)

MOBILE

(5)

OTHER BENEFITS

ELIGIBILITY

(a)

DAILY ALLOWANCE
HEAD QUARTER
EX-HEAD QUARTER
OUTSTATION

(b)

INTERNET

(c)

ANY OTHER

Existing (Per Annum)(Rs.)

6.

Present Hierarchy (Organogram) of your department / function:

7.

Achievements:

(Please show your position with an asterisk mark)

What do you regard as the most significant achievement in your CAREER / ACADEMICS?

8.

Interests & Hobbies:

9.

Career Choice: Short Term & Long Term Career Objectives

10.
References: From Present & Past Employer / College (for fresher)
Name & Designation
Organization
Email Address
Address & Telephone No.
& Fax No.
1)
2)

3)

11.

Have you been interviewed earlier with Flamingo? If so, state the post applied for and its outcome.
________________________________________________________________________________________

12.

Expected Salary: ________________________

When can you join us, if selected: _____________________

13.

Have you been convicted earlier under criminal law and / or any pending legal proceedings in Court of Law?
If yes, give details.
________________________________________________________________________________________

14.

Have you been debarred as per the section 306(K) of the Federal Food, Drug, and Cosmetic Act ?
________________________________________________________________________________________

15.

Are you a member of political / social organizations? If yes, mention its names.
________________________________________________________________________________________

16.

Additional Information: _____________________________________________________________________

I hereby declare that the information given herein above is true to the best of my knowledge and belief.
Place:
Date:

Applicants Signature