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FORTUNA ENGINEERING PVT. LTD

Employment Application Form

PLEASE ANSWER EACH COLUMN FULLY IN OWN HANDWRITING.

(USE ADDITIONAL SHEET IF NECESSARY) POST APPLIED FOR

PLEASE  IN THE  WHEREVER APPLICABLE EXPECTED SALARY ( PER MONTH )

PLANT LOCATION :-
NAME IN FULL ( IN BLOCK LETTERS BEGINNING WITH SURNAME )

MR. / MRS. / MS.

DATE OF BIRTH AGE PLACE OF BIRTH MARITAL STATUS NO. OF CHILDREN

PLACE:  SINGLE  MARRIED
STATE:  WIDOWED  DIVORCEE
PRESENT ADDRESS PERMANENT ADDRESS

PHONE NO. OFFICE RESIDENCE : MOBILE :

EMAIL ID.:
PAN CARD : DRIVING LICENCE NO:
IN CASE OF EMERGENCY (CONTACT PERSON) : EMERGENCY CONTACT NO:

FAMILY DETAILS : (Please provide details of your parents, spouse and children)
NAME RELATION PROFFESION DATE OF BIRTH

EDUCATIONAL QUALIFICATION: Full time education details; starting from 10th/SSC: (For Degree/PG courses, please
mention each year on separate line). Please specify part time courses with an Asterisk *:

EXAM PASSED BOARD / UNIVERSITY PERIOD SPECIALIZATION % of Marks

FROM TO
10 /SSC
th

12th /HSC

QR/HR/15-Employee Information Form.7.3.1/00.22.09.2020

 EXPERIENCE
NAME AND ADDRESS OF YOUR PREVIOUS FROM TO TOTAL YEARS LAST DESIGNATION REASON
AND PRESENT COMPANIES (START FROM SALARY FOR
PRESENT COMPANY ) DRAWN LEAVING

MOTHER
LANGUAGES KNOWN
TONGUE
HOBBIES
SPORTS ACTIVITIES

ANY ACHIEVEMENTS

REFERENCES OF ANY TWO PERSONS WHO ARE NOT RELATED TO YOU

NAME ADDRESS & EMAIL ID PHONE NO. OCCUPATION

UAN NO : ESIC NO :

HAVE YOU BEEN INTERVIEWED IN OUR COMPANY BEFORE  YES  NO

HAVE YOU BEEN EMPLOYED IN OUR COMPANY BEFORE  YES  NO
HAVE YOU BEEN DISMISSED / DISCHARGED / TERMINATED FOR ANY OF YOUR MISCONDUST IN YOUR
PREVIOUS EMPLOYMENT OR CONVICTED FOR ANY CRIMINAL OR OTHER OFFENCES
 YES  NO
IF SELECTED, TIME PERIOD REQUIRED TO JOIN US

I CERTIFY THAT THE ABOVE STATEMENTS ARE TRUE, AND CORRECT. IN CASE IF COMPANY FINDS AT ANY TIME THE INFORMATION
GIVEN BY ME IN THIS APPLICATION FORM IS NOT CORRECT, OR FALSE OR INCOMPLETE, COMPANY HAVE THE RIGHT TO WITHDRAW
MY APPOINTMENT BEFORE / AFTER JOINING MY SERVICES AND CAN ALSO TERMINATE MY SERVICES AT ANY TIME WITHOUT ANY
NOTICE OR COMPENSATION.

SIGNATURE : DATE :

NOT TO BE FILLED IN BY THE APPLICANT

INTERVIEW BY : DATE : SALARY :

DECISION :

QR/HR/15-Employee Information Form.7.3.1/00.22.09.2020