RP/AP/02

Applied Innovation & Technology Group

Application for Employment

(To be completed by the candidate in his own handwriting)

1. Position Applied for

2. Name

3. Date of birth 4. Age

5. Marital status

6. Nationality

7. Father’s / Husband’s name

8. Guardian’s name / Occupation

9. Family Details

Dependent
Name Age Occup. Relation Monthly income
YES NO

10. Present address: 11. Permanent address:

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Mobile No.: Mobile No.:

Landline No.: STD ( ) Landline No.: STD ( )

No.: No.:

E-Mail ID: E-Mail ID:

12. Source of information about this vacancy:

Employment Exchange News Paper Consultant Other Source

Health:
13.Height CM and Weight KG

14. Physical disability (If any)

15. Any major illness, operation or accident. (Give details)

16. Ever interviewed by us before for any position. (Give details)

17. State your interest / hobbies / sports etc, if any including distinction achieved.

18. Particulars of membership / position of authority in professional / cultural

organization.

19. Languages known:

Language Speak Read Write Understand

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English
Hindi
Marathi

20. Details of Educational / Technical qualifications (Matriculation onwards):

Board /
Academic Year of Specialized
University / Class / Rank % of Marks
Qualification Passing Subject
Institute

21. Details of any distinction achieved in studies.

22. Do you plan to pursue your studies further? If so, give details.

23. In case of Typing / Computer Operator / Stenographers, state speed in typewriting

with perfect accuracy of transcription

24. Give details of previous Employment: Total Experience as on:

Period
Name & Address Salary
Designation Reason For Leaving
of Employer From To Drawn

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25. Current Salary Details

Other
Monthly Amount Other Monthly Amount Amount
Sr. Yearly
Income (PA) income (PM) (PA)
Income

1 Basic

2 HRA

3 Conv
Washing
4
Allow
Other
allow
5

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7 Total PM (B)
TOTAL TOTAL
8
(A+B) PM PA (D)
TOTALP
TOTAL PA (C)
A(C+D)

26. Space for additional information about your suitability for this post

27. Whether you know driving Car / Scooter / Motorcycle? If so, your driving licence No:

28. Have you ever been convicted by any Court of Law (Give details)

29. Have you ever been connected with any political activities? If so give details?

30. Minimum salary expected

31. Period required to join (If selected)

32. Reference: Responsible person, not a relative of the applicant but closely acquainted
with applicants academic and professional work.

1. Name: 2. Name:

Add: Add:

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Mob No.: Mob No.:

Email: Email:

33. Salary Details after negotiations

Particulars Per Month Per Year

a. Present CTC ( Gross + Annual Benefits )

b. Expected CTC

c. Required time to join

I hereby certify that the aforesaid

information is correct and complete to the best of my knowledge and belief
and nothing has been concealed therein. I authorize Company verify these
details themselves or by any third party agency hired by them.

I am not aware of any circumstances, which might impair my fitness

for employment. If at any time, I am found to have concealed any material
information or given any false details my appointment shall be liable to
summary termination without notice or compensation.

Date: Signature of Applicant

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For Office Use Only

Interviewed by:

Date of Interview:

Rating:

INTERVIEW REMARKS:

1. Dept. Head:

SIGNATURE

2. HRD.:

SIGNATURE

Final Remarks:

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SIGNATURE

Remarks: Selected Salary Offered

Pending Grade Level

Rejected Date of Joining

Documents:

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