EMPLOYMENT FORM

NAME: _____________________________________________ DATE OF JOINING _________________________

(In capitals)

DESIGNATION: _________________________________________________ E CODE: _________________________

LOCATION: __________________________

Local/ Present address: Permanent Address:

City: Pin code: City: Pin Code :

Personal e-mail: State:

Res. (landline): Local Cell: Res. (with STD code): Outstation Cell:

Official date of birth

(dd/mm/yyyy)

Employee Blood Group

1
P +91.40.3041.9999 F +91.40.3041.9988
590A Road 31, Jubilee Hills
Hyderabad, AP 500033
 FAMILY BACKGROUND (Please mention the dates, wherever requested)

Date of Birth Daughter

Spouse’s Name
(dd/mm/yyyy) (Name &
DOB)
Wedding Date Son
(dd/mm/yyyy) (Name &
DOB)
Mother
Father (Name &
(Name & DOB) DOB)

Sister(s)
Brother(s)
(Name &
(Name & DOB)
DOB)

Sister(s)
Brother(s) (Name &
(Name & DOB) DOB)

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P +91.40.3041.9999 F +91.40.3041.9988
590A Road 31, Jubilee Hills
Hyderabad, AP 500033
ACADEMIC RECORD

- Kindly do not use any abbreviations for stream/ subject specialisation or university/ institute names
- Under the qualification column, pls indicate the name of the degree/ diploma (for e.g.; B.E., B.Tech., B.A., B.Com. etc)
* FT-Full-time, DL- Distance learning/ Correspondence, PT-Part-time

QUALIFICATION STREAM/ UNIVERSITY & INSTITUTE/COLLEGE JOINING COMPLETION DURATION MARKS GRADE/
TYPE OF COURSE:
(Name of the SPECIALIZATIO LOCATION & LOCATION DATE DATE OF THE (%) DIVISION
Degree/ Diploma) N DD/MM/YYYY (DD/MM/YY) ( FT / DL/
COURSE
PT)*
(IN YEARS)
GRADUATION

PG

ANY OTHER
COURSE

ANY OTHER
COURSE

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P +91.40.3041.9999 F +91.40.3041.9988
590A Road 31, Jubilee Hills
Hyderabad, AP 500033
PASSPORT DETAILS (If applicable)

PASSPORT NUMBER DATE OF ISSUE VALID TILL

VALID VISA DETAILS (If applicable)

TYPE OF VISA DATE OF ISSUE DATE OF TYPE OF

EXPIRY ENTRY

PAN CARD NUMBER* (Mandatory)

AADHAAR CARD NUMBER* (Mandatory)

REFERENCES (If applicable)

PLEASE GIVE DETAILS OF YOUR RELATIVES/ FRIENDS/ ACQUAINTANCES WORKING IN ANY OF THE WORLD-WIDE OFFICES
OF GLOBALLOGIC (IF APPLICABLE)
NAME DESIGNATION & OFFICE LOCATION RELATIONSHIP WITH YOU

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P +91.40.3041.9999 F +91.40.3041.9988
590A Road 31, Jubilee Hills
Hyderabad, AP 500033
EMPLOYMENT HISTORY

(IN REVERSE CHRONOLOGICAL ORDER – Start with the last employer and go back to the first)

- Pls do not include the student trainee period in your total experience

ORGANISATION DESIGNATION JOINING DATE LEAVING ANNUAL

(Name & Address) (DD/MM/YYYY DATE CTC
) (DD/MM/YYYY
)

Pls indicate, if there have been any gaps in your career: (If applicable)

FROM (DD/ MM/ TO (MM/ DD/ REASON FOR THIS GAP

YYYY) YYYY)

TOTAL EXPERIENCE (In years and months): _______________________

The information furnished above is true to the best of my knowledge and I shall be personally liable for any
discrepancy found in same.

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P +91.40.3041.9999 F +91.40.3041.9988
590A Road 31, Jubilee Hills
Hyderabad, AP 500033
Signature: ___________________

Declaration of Fitness for Work

Date: _______

1. I understand that while GlobalLogic maintains a flexi time policy, wherein, an employee may be required on
occasion, to put in lengthy hours of work. This may include working late in the office as well as taking calls from
home.. I declare that I have no chronic medical condition that poses any risk to my doing so.

2. I understand that GlobalLogic has an open office environment and I will come in physical contact with my
colleagues, clients and other business acquaintances. I declare that I have no contagious medical condition that poses
any risk to others to any degree, by possible transmission through means including but not limited to physical contact,
air and water, in the course of normal business interactions with others. .

3. I understand that GlobalLogic may require me to travel by air from time to time, both domestically and
internationally, and the GlobalLogic standard policy is to fly economy for all employees. Some of these flights can be
very long in duration such as flights from India to America, which may take over 20 hours. I declare that I have no
medical condition that poses any risk to my doing so.

Employee Signature_______________________

In case any of the statements above are not true, please provide full details below.

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P +91.40.3041.9999 F +91.40.3041.9988
590A Road 31, Jubilee Hills
Hyderabad, AP 500033