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Pre-Screening Form
First Name (As it appears in your passport/official Documents) Middle Name Last Name
A. Personal Details
1. Details of Birth
Date (dd/mm/yyyy) Current Location Age
2. Personal Email-ID
4. Permanent Address (if different from the current address)
3. Current Address
City Pin Code City Pin Code
Telephone (Land Line) Telephone (Land Line)
Mobile 1 Mobile 2
B. Family Details (father, mother, spouse, children, brothers / sisters)
S. No Relationship Name Occupation Location
1 Father
2 Mother
3 Spouse (if any)
4 Siblings (1)
(2)
5 Father in Law
6 Mother in Law
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7 Other (Kids)
C. QUALIFICATION DETAILS
1. Academic
Board Name
(for school
Full Time/Part Year
Educational exam) Course/ Marks Obtained
School/College/University Time/Distanc
History Degree/ Specialization (Percentage/CGPA)
e Learning
Discipline
From To (post-school)
10th
12th
Graduation
Post-Graduation
Other
Education/Special
Training
D. EXPERIENCE
1. Professional Employment Details
S. No Name of the Employer From To No. of months Designation KRA Reason for Change
worked
2. Joining Availability
Joining Availability (Fill whichever applicable)
Immediate (Y \ N)
Minimum Days Required
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3. Experience Details
Mention in detail, the name of client or Industry and positions you have handled
Client/Industry Name Positions Handled
Payable at target Amount received
Q1
Variable Pay
(If applicable) Q2
Q3
Q4
4. CTC Details*:
Current CTC
Fixed
Take Home
Expected CTC
5. Please provide references (from your current & previous employment)
Name Company & Designation Contact Number Email ID
*Supporting documents must be submitted as and when required.
Why you want to change your current job? _____________________________________________________
_____________________________________________________
_____________________________________________________
_________________________________________________
I certify that all the foregoing statements are true and complete. I understand and agree that in case anything contained in this
application is, at any time, found contrary; my appointment may be treated as null and void at the discretion of the Management.
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DATE: SIGNATURE:
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