Saint-Gobain Glass India Ltd.

A-1 SIPCOT Industrial Park,

Sriperumbudur 602 105,
Kanchipuram District,
Please affix your latest colour
photograph (passport size)

Tamil Nadu

Position applied for

Name in Full (BLOCK LETTERS)

KAGITHAPALLI

SIVAKANTH

Surname

First Name

Permanent Address (BLOCK LETTERS)

DOOR NO-1-7-019, PLOT NO:25, G.N.NAIDU
HOUSING COLONY, METTAKUR, YANAM,
PIN:533464.

Middle Name

Present Address (BLOCK LETTERS)

ROOM NO:95, A-BLOCK, PEC HOSTELS,
PONDICHERRY ENGG COLLEGE,
PUDUCHERRY, PIN:605014

Tel No

9790224989

Tel No

Mobile No

9444370303

Email ID

sivayanam@gmail.com

A. PERSONAL DATA
Date of Birth

20-May-92

Age

Birth Place

Yanam

State of Domicile

Andhra Pradesh

Nationality

Indian

Do you have a passport?

no

Passport No

Years

Date of Expiry

Gender

male

Blood Group

Marital Status

un married
1

mole on right hand middle finger

mole on left arm

Two Identification Marks

Height

172

cms

Previous major illness/physical handicap, if any

Eyesight, if corrected. Power used

Weight

60

kgs

no
Right

-0.75

Left

0.5

In case of emergency, the person to be notified

Name
Address

Telephone No

K.SIVATEJA

Relationship

Brother

Mobile No

9790225989

SRK hostel, Pondicherry University

Application
Form

B. Family Background
Relationship

Name

Occupation

Place of Residence

Father/Guardian

K.SIMHACHALAM

PRIVATE EMPLOYEE

YANAM

Mother

K.ARUNA KUMARI

HOUSE WIFE

YANAM

Brother / Sister

K.SIVATEJA

STUDENT

PUDUCHERRY

Read

Write

Brother / Sister
Brother / Sister
Brother / Sister

C. LANGUAGE FAMILIARITY (Please mark (#) wherever applicable)

Speak

Languages

Fluent

Moderate

Nil

Fluent

Moderate

Nil

Fluent

Mother tongue

TELUGU

Others

ENGLISH

HINDI

TAMIL

Moderate

Nil

D. ACADEMIC BACKGROUND
(Please include sequential details on School, College, University & Post Graduate Education)
FT/
PT/
C#

From

To

Degree/Diploma
Awarded

JAWAHAR NAVODAYA VIDYALAYA FT

2006

2007

SSLC / 10TH

FT

2007

2009

HSC

PONDICHERRY ENGG COLLEGE FT

2009

2013

B.TECH

School/College/Institute

REGENCY JUNIOR COLLEGE

Year

Main Subjects
ENGLISH, TELUGU,
MATHEMATICS,
SCIENCE,SOCIAL
MATHEMATICS,PHYSICS,
CHEMISTRY

Academic
Division &
Distinctions
Percentage
(if any)
82.2
92.8

CHEMICAL

Engineering
SEMESTER I

4.62

SEMESTER II

6.48

SEMESTER III

6.88

SEMESTER IV

6.85

SEMESTER V

6.97

SEMESTER VI

7.07

SEMESTER VII
SEMESTER VIII
Kindly indicate: (a) for any gap between academic courses and (b) if you have taken more time than the course duration.
# FT Full-time, PT Part-time and C Correspondence.

E. COMPUTER LITERACY (Please mark (#) wherever applicable)

Applications

Proficient

Familiar

MS Office-Word

MS Office-Excel

MS Office-PowerPoint

ERP
Internet
Others (If any)

Not Familiar

F. OTHER CAREER INFORMATION

List down at least 2 significant achievements in your Academics
Stood school first in metriculation,

What are your short-term and long-term plans?

To enter into a company where I can enhance my knowledge and experience and to work finally for a MNC to give my best in the development of the
company

Distinctions, Honours, Awards (Sports, Extra-Curricular and Community) Received

Year

Award

Basis of Selection

Training & Development (Please record the training programmes attended by you)
Programme Title

Institution Name

Programme Details

Month/Year

Inplant Training, If any

From

TO

Name of the Company / Organisation

12/5/2011

12/9/2011

Regency Ceramics Limited

Project title If Any

G. OTHER PERSONAL DETAILS

What are your Strengths and Areas of Improvement?
Strengths
presentation skills, organisation skills

Areas of Improvement

 What are the values and beliefs that have guided your life so far and how do you see them influencing your future?
Being optimistic and endure are

What are the extra-curricular activities you enjoy the most?

Listening to music, Painting

Have you applied for any Saint-Gobain Group Company (India) previously? If yes,
When?

Where?

Department/Position

Outcome

Are you related to anybody employed in any Saint-Gobain Group Company? If yes, kindly give the following details:
Name

Relationship

Department

Details of Membership of Associations (Kindly include membership of professional, social, cultural organisations)
Name of Organisation

From

To

Office Held

Company

H. GENERAL INFORMATION
If selected, I can take the new appointment within

days.

. Are you willing to undergo extensive, long-term training abroad? If not, please state the constraining factors.

. Are you willing to execute a service agreement with the company if it provides specialised training? State Yes or No.

yes

Do you have any location preferences? If yes, kindly state the constraining factors and your location preferences.

Any other information which you think should be taken into account in considering your application.

Give 3 references with whom you have worked or from whom you have received education or who know you professionally. (Other than relatives)
Name

Position held & Organisation

Address & Telephone Nos

G Srinivasan

Associate Professor, Pondicherry

Engineering college.

Puducherry , 9442215600

K Savita

Principal,Regency Jr College

Yanam, 9866662029

P Jena

Faculty, Jawahar Navodaya Vidyalaya Yanam, 8148355629

Years of Acquaintance

I certify that facts stated in this application are true. I understand that any misrepresentation or suppression of information in this form will render my
services liable to being terminated by the company. I have no objection to your enquiry from any of my previous employers on any matters pertaining to
me, if I join the company.

Place:

Puducherry

Date:

12/20/2012

Applicant's signature

THANK YOU FOR TAKING THE TIME TO COMPLETE THIS APPLICATION