GATPL-F/HRR-EAF/01rev00

Employment Application

Position applied for ____________________Date _________ (dd/mm/yy)

Personal Information
Surname Given Name

Preferred Name

Address

PIN Date of Birth

[dd/mm/yyyy]
Home Telephone No. Mobile

Best time to call Personal mail-id

Opportunity Related Information

If hired, when you will be available for joining?
If hired, will you be able to work outside the work hours to meet job requirements & deadlines?  Yes
 No  Need to discuss
If hired, will you be able to work in night shifts?  Yes  No  Need to discuss
Have you ever plead “guilty” or “no contest” to, or been convicted of a crime?

Employment History: All columns must be completed. You may attach a resume, but not in place of completing
the required information. The following information will be treated as ‘Confidential’ and will not be disclosed
to anybody other than those involved in the process.
Present Organization
Address

Starting & Ending Dates Starting & Final Job Title Starting & Ending Salary(C to C)

Reason(s) for leaving

Immediate Supervisor & Title May we contact your immediate supervisor for
reference?  Yes  No  Later
Telephone No (H) Best time to call Mail Id
Telephone No (O) Best time to call

Previous Employment information (in reverse chronological order)

No Company Service: From - To Job Title Responsibilities

(dd/mm/yy)
1
2
3
4

1 of 2
 Education
Certificate Duration Grade/
Name & Location /Dip/Degree Subjects & Major (From-To) Percentage
School
       
Jr. College
       
Grad. College
       
Post Grad. College
       
Any other        
Languages Known (Read, Speak & Write):

Professional References
Name 1 Title Organization No. of years
Known
Telephone No Best Mail Id Relationship
time to
call
Name 2 Title Organization No. of years
Known
Telephone No Best Mail Id Relationship
time to
call

CERTIFICATION & AUTHORIZATION

The above information is true and correct. I understand that, in the event of my employment by the Company, I shall
be subject to dismissal if any information that I have given in this application and otherwise is false or misleading or
if I have failed to give any information herein requested, regardless of the time elapsed after discovery.

I authorize, without reservation, the employer, its representatives, employees or agents to contact and obtain
information from all references (personal and professional), employers, public agencies, licensing authorities and
educational institutions and to otherwise verify the accuracy of all information provided by me in this application,
resume or job interview. I hereby waive any and all rights and claims I may have regarding the employer, its agents,
employees or representatives, for seeking, gathering and using such information in the employment process and all
other persons, corporations or organizations for furnishing such information about me.

This application does not constitute an agreement or contract for employment at any time for any specified period or
definite duration. I understand that the Company may determine not to hire me for any lawful reason.

I understand that no supervisor or representative of the employer is authorized to make any assurances to the
contrary and that no implied, oral or written agreements contrary to the above mentioned, are valid unless they are
in writing and signed by the employer’s Manager-HR / Operation.

If employed, I will provide all original documents (statutory or otherwise) for verification. I also understand that, if
employed, I will be required to sign an Employment Agreement as discussed at the time of my interview/recruitment
process.
DO NOT SIGN UNTIL YOU HAVE READ THE ABOVE STATEMENT.

I certify that I have read, fully understand and accept all the terms of the above Applicant
Statement.

____________
Signature & Date

2 of 2