Campus Application Form

RELIANCE BP MOBILITY LIMITED

GET HIRING

Name

Date of Interview

Location of Interview

Qualification Discipline

Name of Institute
Personal Information

First Name

Middle Name
PHOTOGRAPH
TO BE AFFIXED
Last Name

Date of Birth Age: Sex: Male Female

Marital Status

Birth Place Blood Group

Nationality Identification Mark

Mobile No. Emergency No. & relation with the

person Email ID Residence No.

Facebook ID Twitter ID

(Aadhaar Card number is mandatory. In case you don't

Aadhaar Card no have, kindly obtain the same before your joining)

Present Address

Permanent Address

Family Details

Name Contact No. Qualification Profession Location

Father

Mother

Sibling (1)

Sibling (2)

Sibling (3)
Qualification and Other Details

Qualification From To Institute / Board Grade / % Specialization

(DD/MM/YY) (DD/MM/YY) / University

Graduation (BE /B.Tech)

Higher Secondary (12th)

/ Diploma

Matriculation (10th)

Other Courses /
Certification

Project Undertaken / Internship details (Starting from latest one)

Name of Organization Duration Project / Internship Title

(From MM/YY To MM/YY)

Have you earlier attended test / interviews held by Reliance Industries Ltd.? Yes No

If Yes, When (Date), Position

Are any of your relative(s) currently employed with Reliance Group? Yes No

If yes, Name , Position , Location

3
Help us know you better
1. Where do you see your professional career in the next 2-3 years?

2. What do you like to do in your free time?

3. What are your Strengths & Areas of Improvement? (Mention two)

Strengths Areas of Improvement

4. How will you describe your personality?

5. Who is your role model? Briefly explain why?

6. Your achievements (Academic & Extra Curricular)

Date Signature of the candidate

Disclaimer - I hereby declare that the foregoing statements are true to the best of my knowledge. If at a future date, it is found that any of the information 4
herein is false or incorrect, the company will have the right to terminate my service without any notice or salary in lieu thereof
 1. Medical History:
Reliance BP Mobility Limited

Medical Examination

Have you ever suffered from any of the following (Answer Yes or No. if yes, give details)?

Y N Y N

Heart Disease Hypertension

Diabetes
Chronic
Kidney disease abdominal

Asthma Chronic /digestive

Tuberculosis
Dermatitis or any skin disease
Epilepsy, Fits, fainting or
dizziness
Any allergy
Any major operation or injury
disorder
Hepatitis-B
Lung disease (e.g. bronchitis, pleurisy, pneumonia etc.)
Malaria / Typhoid fever in last 6 months
Venereal or Sexually Transmitted Disease
Nervous / Mental disease of any kind
Any chronic ear or hearing problem (e.g. sinusitis, rhinitis, otitis
etc.)

Any other illnesses

Do you have any physical handicap Details of any of above if "Yes"

2I declare that the above statements are true and complete to the best of my knowledge and belief and I agree that the
results of this medical examination in general terms may be revealed to the company if required. I also fully understand
that in case I am declared medically unfit due to any reason, I shall not be entitled for the employment in the company.
However, the decision taken by the company's doctor/s about my medical fitness will be final and binding to me.

Date (dd/mm/yyyy)
Signature of Prospective Employee