APPLICATION FORM

(Page 1 of 2)

I hereby declare that the information provided herein is true to the best of my knowledge. Any
misrepresentation by me will lead to disqualification of my candidature or termination of employment
without notice . I also authorize Concentrix to send job\recruitment related notifications & updates on my contact
number(s) and email updated with Concentrix.
To be filled by the candidate in CAPITAL LETTERS only. Please do not leave any field blank.
PERSONAL DETAILS

First Name S U D E S H
Middle Name

Last Name S H A R M A
Emergency Contact
Number 9 6 3 9 8 2 8 8 5 9
Father's name MUKESH SHARMA
Present Address ROOM NO. 4 NEAR CANARA BANK SEC 17 SUKHRALI VILLAGE GURUGRAM HARYANA
City GURUGRAM
State HARYANA
Pin Code 1 2 2 0 2 2
HIGHEST EDUCATION Under Graduate Graduate Post Graduate Diploma RESULT Pass Awaited

Name of Degree/
From To Degree/ Diploma / Name of the
Diploma / Board/University
(YYYY) (YYYY) Certificate Institution/School/College
Certificate

BACHELOR DEGREE DR. BHIMRAO AMBEDKAR SREE KRISHNA

2016 2019 OF SCIENCE MAHAVIDHYALAY
UNIVERSITY, AGRA. AGASAULI

Foreign Language
Diploma /
Certificate Course

WORK EXPERIENCE DETAILS (Start from most recent job) Fresher Experienced

Designation at Name, Designation &

From To Name of Organisation Annual Salary
the time of Emp Id Contact Number of
(DD/MM/YYYY) (DD/MM/YYYY) (Branch/Location) (CTC)
Leaving Reporting Manager

DHANI CUSTOMER 294906 SATVINDER 250000

CARE KAUR
15/12/2020 25/04/2022
LOANS&SERVICES EXCUETIVE
9643801885

I authorize, Concentrix or its 3rd party agency to use this for verification purpose with concerned
authorities. I understand and agree that Concentrix holds the right to conduct drug test & background
check on my professional, educational and financial background through independent sources. In case
background check is negative/ drug test is positive, Concentrix to withdraw the offer or terminate my
employment with immediate effect. On joining I will submit authentic copies of all certificates, testimonials
to support the details mentioned in the form.
Applicant's Signature Date (DD/MM/YYYY) : 25/04/2022

CNX/REC/ART/AGHR/AF/9.4
OTHER DETAILS

Aadhaar Number 6 3 2 0 3 8 0 0 8 0 6 3
PAN Number K T S P S 8 2 7 9 C Passport Number

Relocation (if applicable) FROM TO Are you 18 years old or above? Yes No

Do you have UAN / EPF Account Number? Yes No

Have you ever worked with Concentrix / IBM Daksh / Daksh / Minacs / If yes, please share
Yes No
Convergys? Employee ID :

In case you have any Relatives / Friends working in Concentrix, please provide Name, Location, Designation, Department/ Process

NA

In case you have ever worked in / for Concentrix while being employed by a
Date of Joining Last Working Day
vendor/consultant providing services to Concentrix, please specify duration :

Applicant's Signature Date (DD/MM/YYYY) : 25/04/2022

Page 2 of 2

CNX/REC/ART/AGHR/AF/9.4