Robert Bosch Engineering and Business Solutions Limited
Application for Employment
Position applied for Location Bangalore/Coimbatore Date
(Recent Passport Size Photograph to be affixed)
General Instruction Type or print this application form ; Specify all dates using DD/MM/YYYY format ; If not hand written, sign at the bottom of each page Personal Information First Name Date of birth Middle Name Gender Last Name E-Mail ID
Place of Birth: City & State
Mother Tongue
Nationality
Religion Date of Name Change Valid till
Change of Name if Applicable
(Former Name / Maiden Name )
Passport Number Current Address Door No. House Name
Date of Issue
Place of Issue
Street Landmark City Residence phone with STD Permanent Address : Same as Above Door No. House Name Street Landmark City Residence phone with STD Domiciliary state Family Information Marital Status Spouses Name - First Number of children Fathers Name - First Mothers Name - First Middle Middle Middle
State Mobile Number
Pin
State Mobile Number Period of stay
Pin
Date of Marriage (dd/mm/yyyy) : Last No. of dependents (Other than Spouse & Children) Last Last Occupation
Occupation Occupation
Registered Office: 123, Industrial Layout, Hosur Road, Koramangala, Bangalore 560 095, India Telephone : (080) 6657 5757 Telefax : (080)- 6657 1404
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Robert Bosch Engineering and Business Solutions Limited
Education (Begin with the highest education qualification & end with class X; Attach legible photo copies of Mark sheets / Degree Certificate / Provisional Degree Certificate) Course / Degree Post Graduation Graduation Name of Institute / University Year of passing (Month / Year) From To % of Marks /CGPA Class / Rank
Location
Specialization
Diploma Pre-University / 12th Std School / 10th Std Others
Please provide additional information for Post Graduation Post Graduation Percentage Backlogs I SEM II SEM III SEM IV SEM V SEM VI SEM Aggregate
Please provide additional information for Graduation Graduation Percentage Backlogs I SEM II SEM III SEM IV SEM V SEM VI SEM VII SEM VIII SEM Aggregate
Please provide additional information for Diploma Diploma Percentage Backlogs I SEM II SEM III SEM IV SEM V SEM VI SEM Aggregate
Registered Office: 123, Industrial Layout, Hosur Road, Koramangala, Bangalore 560 095, India Telephone : (080) 6657 5757 Telefax : (080)- 6657 1404
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Robert Bosch Engineering and Business Solutions Limited
Professional Work Experience (Present / Last Employment) Company Name Building No. Landmark City Employee ID Current Designation & Department Date of joining Reason for seeking change Supervisors Name & Designation Supervisors Direct Number & Mail Id Type of employment Are you under any bond? Can the employer be contacted now? Reporting structure If yes, specify bond period or amount / period If No, then provide an alternate date to contact Last drawn salary(Annual CTC) State Pin Street Key job responsibilities
(Past Employment) 1. Name of the company Building No. Landmark City Date of joining & Leaving Duration of employment Reason for seeking change 2. Name of the company Building No. Landmark City Date of joining & Leaving Duration of employment Reason for seeking change Please use additional sheet (annexure I) if space is not sufficient. Technical & Domain skills (List skills which relate to the position applied for & rate them as per scale defined) Last drawn salary State Pin Street Key job responsibilities
Last drawn salary(Annual CTC)
Key job responsibilities Street
State
Pin
Registered Office: 123, Industrial Layout, Hosur Road, Koramangala, Bangalore 560 095, India Telephone : (080) 6657 5757 Telefax : (080)- 6657 1404
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Robert Bosch Engineering and Business Solutions Limited
1 Basic Awareness; 2 End user; 3 Require guidance; 4 Can deliver independently; 5 Ability to train / guide others Skill Description Self Evaluation
Training / Development Program / Certification (Specify date in dd/mm/yyyy format) Program Name & Location of Institution Details From(Date) To(Date)
REFERENCES Details of persons under whom you have either worked or who know you professionally for at least 6 months Name Organization & Designation Nature of Association Duration E-Mail ID Phone No. (With STD Code) Residence Office
Details of friends / relatives employed in BOSCH Name Organization & Designation Nature of Association Duration E-Mail ID Phone No. (With STD Code) Residence Office
Registered Office: 123, Industrial Layout, Hosur Road, Koramangala, Bangalore 560 095, India Telephone : (080) 6657 5757 Telefax : (080)- 6657 1404
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Robert Bosch Engineering and Business Solutions Limited
Additional Details Professional Achievement Membership of Professional Association Research Papers / Articles published Patents / License Registered
Interests Achievements in Sports, Literary activities etc. Awards received Hobbies & Special Interests
Health Height (Cm) Weight (Kg) Blood Group Physical handicaps, if any, please provide details
Have you suffered from any major illness / Surgery / accident in the last five years? Chronic illness if any (high blood pressure, diabetes, etc) Information on major surgical operations if any Information on most recent illness, if any
If yes, please provide details
Statutory Membership Are you a member of Employees Provident Fund Scheme (EPF)? Are you a member of Family Pension Scheme (EPS)? Are you a member of Employees State Insurance Scheme (ESI)?
Account Number
Contact person in case of emergency (preferably local) : Name Door Number House Name Street Landmark City Residence phone with STD Relationship
State Mobile Number
Pin
Registered Office: 123, Industrial Layout, Hosur Road, Koramangala, Bangalore 560 095, India Telephone : (080) 6657 5757 Telefax : (080)- 6657 1404
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Robert Bosch Engineering and Business Solutions Limited
Language Proficiency Language Can Speak Can Read Can Write
Other Details Have you ever worked with any of the BOSCH entities in the past? Have you been interviewed by Bosch before?
If Yes, provide details If yes, provide details (Division / Location / Month / Year)
Have you ever been arrested, prosecuted or convicted for any criminal offence, other than minor traffic offences Social security no. / any ID no. issued by competent Government office Do you have any commitment to another employer or organization that might affect your employment with us?
If Yes, provide details
If Yes, specify the details
If Yes, provide details
Any other information you would like us to know which may have significant bearing on our hiring decision? If Yes, provide details Certification by Candidate I certify that the statements made by me above are true, complete and correct. I agree that in case the company finds at any time, the information provided by me in this application form is not correct or untrue or incomplete, the company will have the right to withdraw, if selected, the letter of appointment before I join the services or to terminate my appointment at any time without notice or compensation after I have taken up service.
I authorize Robert Bosch Engineering and Business Solutions Limited or its agency to verify my credentials. I will cooperate and facilitate the process of verification of my credentials / antecedents.
Name of the applicant
Date
Place
Signature
Registered Office: 123, Industrial Layout, Hosur Road, Koramangala, Bangalore 560 095, India Telephone : (080) 6657 5757 Telefax : (080)- 6657 1404
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Robert Bosch Engineering and Business Solutions Limited
Professional Work Experience (Annexure I) 3. Name of the company Building No. Landmark City Date of joining & Leaving Duration of employment Reason for seeking change 4. Name of the company Building No. Landmark City Date of joining & Leaving Duration of employment Reason for seeking change Last drawn salary(Annual CTC) State Pin Street Key job responsibilities Last drawn salary(Annual CTC) State Pin Street Key job responsibilities
5. Name of the company Building No. Landmark City Date of joining & Leaving Duration of employment Reason for seeking change Street
Key job responsibilities
State
Pin Last drawn salary(Annual CTC)
6. Name of the company Building No. Landmark City Date of joining & Leaving Duration of employment Reason for seeking change
Key job responsibilities Street
State
Pin Last drawn salary(Annual CTC)
Name: Date: Signature
Registered Office: 123, Industrial Layout, Hosur Road, Koramangala, Bangalore 560 095, India Telephone: (080) 6657 5757 Telefax: (080) 6657 1404
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Robert Bosch Engineering and Business Solutions Limited
Remuneration Details : Annexure II Name: Please furnish your present remuneration details. Compensation Element 1. Cash components per month: Basic Salary Dearness Allowance House Rent Allowance Conveyance Allowance Childrens Education Allowance Special Allowance Other Perquisites Gross Salary per month 2. Retirals: PF Gratuity Superannuation Total Per month 3. Cash components per annum: Incentives Bonus LTA Other Perquisites Total CTC ((1+2) X 12 +3 ) Deductions / Recoveries, if any CTC Per Annum Expected CTC Per Annum I certify that the particulars furnished by me are correct. Date of last salary revision: Date of next salary revision: Amount (Rs.) Remarks
Date :
Signature
Note: Please attach a copy of last drawn salary slip / other endorsement in support of the above particulars.
Registered Office: 123, Industrial Layout, Hosur Road, Koramangala, Bangalore 560 095, India Telephone: (080) 6657 5757 Telefax: (080) 6657
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