Accenture Services Private Ltd Doc Ver 2.

Employment Application Form

For internal use only: To be filled by Accenture

Employee ID Number: Please attach recent
Date of Joining :
passport size
Workforce :
photograph
 Please provide complete and correct information.
 All fields are mandatory.
 Please do not use short forms / abbreviations.
 Hardcopy of this form along with supporting documents has to be submitted (duly
signed & with a recent colour photograph) to your location contact point.
 Personal Details
Please expand initials in your name -- As the same would be used in our Employment records

Title (Mr./Ms.) First Name Accenture

Middle Name Services Private
Last NameLtd Doc Ver 2.6

Ms. Chanchal Education Details Garg

Primary Skill
Qualification with / SAP
Institution ABAP
Name & City University Name & City Period Student ID / Program % age marks /
Specialization
Competency(School/College) / Board Affiliated To (From – To) Reg No. (Part Time / Full CGPA
(Starting from most (dd/mm/yyyy) Time)
recent)
MCA Gender: Female
BPIPSo,Delhi Nationality:GGSIP
…Indian .... Citizenship: …………………….
University 15/07/2004 Full Time 85.5%
20/04/2007
Date of Birth : ………08/04/1984………… Place of Birth:………Haryana…….

Maiden Name: (applicable for married ladies): ……………………………………….

Bsc(Comp.Sci) DDU,Karampura,Delhi Delhi University 21/07/2001 Full time 73%
Father’s Name: Mr. Subhash Garg 20/6/2004

Mother’s Name: Mrs. Saroj Garg

HSC/ 12th Mother’s GRJPS,Rohini

Maiden Name: ,Delhi C.B.S.E
………………………………….. 1/4/2000 Full time 73%
31/3/2001
Contact Number/s: 9582945413

Personal Email ID: cgsaptechnical@gmail.com

SSC/ 10th Modern Era Convent, C.B.S.E 1/4/1998 Full Time 78%
Janakpuri,Delhi
Alternate Email ID: chanchalgarg83@gmail.com 31/3/1999

Current Address : Permanent Address :

Others
House No-2 ,Sec- 4 Pkt – A-1 Rohini House No-2 ,Sec- 4 Pkt – A-1 Rohini
Delhi -110085 Delhi -110085

State reasons for gap in education (if any) :

Phone Number : 011-27056569 Phone Number :

Current Address Permanent Address

From To From To
Period Of Stay (month/year) (month/year) (month/year) (month/year)
Mar 2000
Till now

If you do not have a Passport, it is recommended that you apply for the same before joining.

Passport Number : G0675563

 Accenture Services Private Ltd Doc Ver 2.6

Employment Details (Please mention all the employments starting from the latest employment)
Note: Verification of your current employment would be obtained on or after joining Accenture.
Sl Company Address Employment Reported to (Name Employme Emp Code / Last drawn Reasons for Mode of separation
No Name (Main office & branch Type & Position & direct nt Period Personnel monthly leaving from the organization
where worked) with & contact number) From - To No. / Social gross (Pls select the below
Company Telephone Designation/ (dd/mm/ Security No. salary (INR) option)
– Board Line Position held yyyy) (Mandatory if
worked in
USA)
Wipro BPO Wipro ,Okhla Atul Kapoor, May 2010 583018 37500 Career □ Resignation
Industrial Area □ Permanent Till now Growth
Employer 1

Rishikesh
Ph-011-30944747 Designation

SAP HCM
Consultant
SCO 850,Chandigarh Prateek Aug2009 to 30000035 25000 Career □ Resignation
Ind-Swift Labs Ph-2730503 □ Permanent 9781361382 may 2010 Growth
Employer 2

Limmited
Designation

SAP Technical
Consultant
Hexaware MBP,Navi Mumbai Pankaj Sept 2007 15571 18357 Career □ Resignation
Technologies □ Permanent to Mar 2009 Growth
Employer 3

9892248303
Designation

Associate S/W
Eng..
□ Permanent □ Resignation
Employer 4

□ Contract □ Termination
□ Absconded
Designation □ Closed the operations
□ Others(Pls specify)
…………………..
□ Permanent □ Resignation
Employer 5

□ Contract □ Termination
□ Absconded
Designation □ Closed the operations
□ Others(Pls specify)
…………………..
 Accenture Services Private Ltd Doc Ver 2.6

• Ensure that you are descriptive wherever necessary – e.g. If your previous company is closed down, please do mention it. Telephone Number with
specific location code, Employee Code/ ID/ Number is mandatory. If your previous employer did not provide the Employee ID, please mention and state
reasons for the same
• Employment details should be of the company you are on payrolls of, not of a company you are deputed to on an assignment with. In case you are
showing employments experience in a skill enabling or professional Training institute the same should only be shown if you were on the payrolls of such
an institute.
 Accenture Services Private Ltd Doc Ver 2.6

Letter of Authorization
To whom it may concern

If employed by Accenture, I agree to provide copies of mark sheets and relevant certificates. I understand
that employment with Accenture is governed by Accenture Employment Policies as applicable, including
satisfactory information from a background check
.
I hereby certify all of the statements made on the Accenture Services Private Ltd Employee Application
Form are true and complete and I understand that omission or misrepresentation of any fact may result in
refusal of employment or immediate dismissal.

I hereby authorize Accenture Services Private Ltd and its representative to verify information provided in my
resume and application of employment, and to conduct enquiries as may be necessary, at the company's
discretion. I authorize all persons who may have information relevant to this enquiry to disclose it to
Accenture Services Private Ltd. or its representative. I release all persons from liability on account of such
disclosure.

Signature : Chanchal Garg

Name in Capitals : CHANCHAL GARG

Date : 16/7/2010

For internal use only: To be filled by Accenture

*Signature of the Recruiter :

Name of the Recruiter :

Date :

* The Signature of the recruiter needs to be present in case the application is sent as soft copy and
does not have the signature of the candidate.

The hardcopy of the email received also needs to be submitted along with this form as an audit trail.