EMPLOYMENT
FORM
NOTES
This form should be completed in own handwriting by the candidate.
This form is intended to ensure a fair assessment of education, experience
and trainings attended.
Please use the sheets for additional information to amplify any item you
consider needs full explanation.
Recent passport size photograph should be enclosed.
Space for
Photograph
POST APPLIED FOR
1.
Personal Particulars:
First Name: Mr/Mrs/Miss ___________________ Middle Name: ___________________ Surname: ___________________
(CAPITAL LETTERS)
Permanent Address:
__________________________________________________________________________________________________
___________________________________________________________________ PIN Code: ______________________
Present Address:
__________________________________________________________________________________________________
___________________________________________________________________ PIN Code: ______________________
Contact: Resi: _______________ Office: _________________ Mobile: _________________ Email: __________________
Date of Birth: __________________
Place of Birth: _______________
Gender: Male/Female
Nationality: ___________________ Blood Group: ______________ Height: __________ cms. Weight: _________ kgs.
PAN No: ______________________ Passport No.: ___________________ Marital Status: Yes / No. ________________
(If yes, date of Marriage)
Mark of: __________________________ Residing At: ________________ Do you own a vehicle: __________________
Identification
(Own / Rented House)
(Two / Four Wheeler)
Aadhaar Card No: ____________________________
Details of Family: (including parents)
Name of Family Member
Date of Birth
Relationship
Occupation
Details of any serious illness, operation or accident
resulting in incapacitation for a month or longer: _________________________________________________________
Do you have any physical disability? If so, please state nature and degree: ____________________________________
Name & Address of person to be contacted in case of emergency: ___________________________________________
__________________________________ Relationship: _______________ Tel: No.: ___________________________
Are you a member of the Employee Provident Fund Scheme? If yes Account No.: _______________________________
2.
Languages Known: Indicate against each language whether fluent, fair or slight
Language
Speak
Read
Write
3.
Education: Begin with School Leaving Examination.
Degree / Diploma
Certificate
4.
Year of
Examination
Name of School / College and
University
Subject of Study
(Indicate specialized subject with an
asterisk*)
Working Experience: Begin with present employer, then previous
Period
From
Division /
Class
Name & Address of the employer
Designation
CTC p.a.
To
Job Description: In continuation to the above table
Reporting To
Products Handled /
Area of Work
Duties / Role Performed
Reason for Leaving
5.
Sr. No.
Details of the Salary Structure (with present employer)
Particulars
Designation
1.
BASIC
2.
FIXED DEARNESS ALLOWANCE
3.
VARIABLE DEARNESS ALLOWANCE
4.
HOUSE RENT ALLOWANCE
5.
CONVEYANCE ALLOWANCE
6.
EDUCATIONAL ALLOWANCE
7.
TELEPHONE ALLOWANCE
8.
ANY OTHER ALLOWANCE
TOTAL (1 to 8)
REIMBURSEMENT
i.
MEDICAL
ii.
LEAVE TRAVEL ASSISTANCE
iii.
DRESS ALLOWANCE
iv.
MEDICLAIM
v.
ESIC
vi.
ANY OTHER COMPENSATION
TOTAL (i to Vi)
INCENTIVES
a.
BONUS / EX-GRATIA
b.
INCENTIVE (VARIABLE & FIXED)
c.
a+b
RETIRAL BENEFIT
I.
PROVIDENT FUND
II.
GRATUITY
III.
SUPERANNUATION
TOTAL(I to III)
TOTAL CTC=(A + B+C + D)
OTHER BENEFITS
(1)
PERSONAL ACCIDENT INSURANCE
(2)
MEDICAL INSURANCE
(3)
CAR
(4)
MOBILE
(5)
OTHER BENEFITS
ELIGIBILITY
(a)
DAILY ALLOWANCE
HEAD QUARTER
EX-HEAD QUARTER
OUTSTATION
(b)
INTERNET
(c)
ANY OTHER
Existing (Per Annum)(Rs.)
6.
Present Hierarchy (Organogram) of your department / function:
7.
Achievements:
(Please show your position with an asterisk mark)
What do you regard as the most significant achievement in your CAREER / ACADEMICS?
8.
Interests & Hobbies:
9.
Career Choice: Short Term & Long Term Career Objectives
10.
References: From Present & Past Employer / College (for fresher)
Name & Designation
Organization
Email Address
Address & Telephone No.
& Fax No.
1)
2)
3)
11.
Have you been interviewed earlier with Flamingo? If so, state the post applied for and its outcome.
________________________________________________________________________________________
12.
Expected Salary: ________________________
When can you join us, if selected: _____________________
13.
Have you been convicted earlier under criminal law and / or any pending legal proceedings in Court of Law?
If yes, give details.
________________________________________________________________________________________
14.
Have you been debarred as per the section 306(K) of the Federal Food, Drug, and Cosmetic Act ?
________________________________________________________________________________________
15.
Are you a member of political / social organizations? If yes, mention its names.
________________________________________________________________________________________
16.
Additional Information: _____________________________________________________________________
I hereby declare that the information given herein above is true to the best of my knowledge and belief.
Place:
Date:
Applicants Signature
