PERSONAL DATA FORM

AFFIX
PASSPORT
SIZE
PHOTOGRAPH

Post Applied For

Name (IN BLOCK LETTERS)
Father’s Name
Mother’s Name
Date of Birth
Present Address

Mobile Number
Telephone Number
E- Mail
Permanent Address

Mobile Number
Telephone Number
E- Mail
Marital Status
No. of Dependents
Family Details
Name Relation Age Occupation

Prepared By: Reviewed & Approved By: 1

 Qualification : ( Academic/Professional/Technical)
Degree/Diploma Passing Year College /Institute %age of Marks

A. TOTAL EXPERIENCE: ---------------------- YEARS ------------- MONTHS

B. DETAILS OF EXPERIENCE:
EMPLOYE EMPLOYER’ DESIGNA PERIOD GROSS BRIEF REASON FOR
R’S NAME S BUSINESS -TION OF SALAR DESCRIPTIO LEAVING
& & ANNUAL HELD EMPLO Y N OF
LOCATION TURNOVER Y- DRAWN FUNCTIONS
MENT (P.A.) AND DUTIES
PRESENT

PREVIOUS

2nd LAS T

3rd LAST

Prepared By: Reviewed & Approved By: 2

ORGANIZATION CHART: PLEASE GIVE YOUR POSITION IN THE COMPANY
STRUCTURE OF THE CURRENT / LAST EMPLOYMENT.

CURRENT:

PREVIOUS

ARE YOU PREPARED TO WORK ANYWHERE IN INDIA: (YES/NO)

OUTLINE / MENTION YOUR PERSONAL STRENGTHS:

Do you know or are related to someone in IQMS if yes please give details:

Present Remuneration: Details Monthly

Basic HRA Conveyance LTA MEDICAL BONUS OTHERS TOTAL
(Rs.) (Rs.) (Rs.) (Rs.) (Rs.) (Rs.) (Rs.) (Rs.)

Total Salary Cost to the company:

Expected Salary ( Cost to the Company)
Notice Period to be given to the present employer:
Can we make reference to your past employers expect your present one: Yes/ No

Name & Signature Date:

Place:

Prepared By: Reviewed & Approved By: 3

Reference: Please give name, address telephone number & email ID of two references
Name Relation Address with telephone/mobile Occupation E- Mail
number

For Use By HR Only

Position Offered /Location /
Salary Offered
Tentative Joining Date
Remarks
Date Signature

Sectioned By Approved By

Prepared By: Reviewed & Approved By: 4