Interview Date Time No

First Round
Second Round

Deviation Letter AFFIX YOUR

PASSPORT –
DOJ
(dd/mm/yyyy) SIZE PHOTO
HERE

APPLICATION FORM
(Fill with neat handwriting/ typing)
DATE:………………………
POST APPLIED FOR:
FULL NAME:
(In block letters)
APPLIED WITH REFERENCE:
(Recruiter’s Name)
Contact Information :-
Mobile No. Linkedin
Instagram - Email ID
Facebook - Twitter
Personal Information: - Date of Birth: DD/MM/YYYY
Gender Male  Female 
Aadhar Card : Yes  No 
Passport Yes  No 
Marital Status :- Single  Married  Divorced 
Category: General  OBC  SC  ST  If Others (Specify) 
Religion:
Have you been interviewed by us?
YES/NO
If yes, please specify date of interview
Do you know any of our employees/ Ex-employees /
candidates interviewed by us earlier? YES/NO
If yes, please specify name & relationship:
QUALIFICATION DETAILS: (Start with Latest Qualification)
Qualification Specialization School / College Year of %/ Medium of Full/ Part Time /
/ University Passing Grade Education Distance

Name - Page 1 of 6 Signature -

 Are you pursuing/ planning any further educational course? If yes, please specify Yes  No 
____________________________________________________________________________________

MENTION THE APPROPRIATE OPTION YES / NO

Open to Field work
Are you Ready to work in all Three Shifts
Open for travelling for Exhibitions / Seminars in INDIA

ABROAD

PHYSIOLOGICAL INFORMATION:
Addictions: Tobacco  Smoke  Alcohol 

Blood Group Height Weight

Health Issues: BP  Diabetes  Migraine  Vertigo  Depression  Asthma  Back Pain 

Other health issue (If Yes, please specify here)

Physical / Psychological illness (If Yes, please specify)

ADDRESS DETAILS:
CURRENT ADDRESS PERMANENT ADDRESS
Communication Communication
Residence Residence
Address: Address:
City/Dist./ Village: City/ Dist./Village:
Pin Code: Pin Code:
State: State:
Landmark: Landmark:
NATIVE PLACE:

LANGUAGES KNOWN:
Languages Speak Read Write
  
  
  
  

Mother Tongue:-

FAMILY DETAILS:
First Name Middle Name Last Name Date of Birth Relationship Occupation

Name - Page 2 of 6 Signature -

COMPUTER/ SOFTWARE PROFICIENCY:
* TICK “ ” IF YOU KNOW & “X“IF YOU DO NOT KNOW IN SKILL CHECK BOX
* IF YOU KNOW THEN MENTION THE DETAILS IN GIVEN RESPECTIVE COLUMNS.

SOFTWARE SKILL * VERSION/ TYPE BASIC ADVANCE

MS WORD 
MS EXCEL 
MS OUTLOOK 
MS POWERPOINT 
INTERNET 
TALLY 
PHOTOSHOP 
COREL DRAW 
AUTO CAD 
ANSYS 
CREO PARAMATRIC/ PRO ENGINEER 
CATIA 
DRAFT SIGHT 
SOLID WORKS 
SOLID EDGE 
TURBO CAD 

OTHER (PLEASE SPECIFY)

Is there any criminal/civil/legal cases:

1). Filed by you till now Yes  (If yes, give details below) No 

2). Filed against you till now Yes  (If yes, give details below) No 

3). Have you been convicted, Yes  (If yes, give details below) No 
arrested, prosecuted, fined by
any court of law against you

Name - Page 3 of 6 Signature -

 DETAILS OF PRESENT & PREVIOUS ORGANIZATIONS
(Start with Current Employer)

Employment Period Joining Salary Current Reason for

Designation Drawn Salary / Last Leaving
Company Name From To (CTC Per Drawn
&
Location (MM/YY) (MM/YY) Annum) (CTC Per
Annum)

CURRENT JOB DESCRIPTION:

Name - Page 4 of 6 Signature -

 

Current Fixed- CTC p.a.: CTC p.m.: Take Home p.m.:

Variable Pay - p.a.: Variable Pay p.m.: Variable Pay Received:

(In Current FY)

Expected - CTC p.a.: CTC p.m.: Take Home p.m.:

(Fixed + Variable)
Notice Period:

*(Variable Pay denotes your Incentives, Performance Pay, Commission etc...)

CURRENT SALARY BREAK-UP

Details of Break-up Monthly

Basic
HRA
Conveyance Allowance
Medical Allowance
Education Allowance
Special Allowance
+ Telephone
+ Food coupon
+
Gross Per Month
Other Allowance
Bonus
LTA
Leave Salary
Company Contribution to PF
Gratuity
Incentive
+
+
+
+
Monthly CTC

Name - Page 5 of 6 Signature -

Income from any other source? If yes, please specify:

Name & Designation of current Organization references

Reporting Manager Head - HR

Name Name

Designation Designation

Landline No. Landline No.

Mobile No. Mobile No.

E-mail ID E-mail ID

I understand that this application does not constitute an offer of employment. I hereby
declare that the information given in this application is true and correct to the best of my
knowledge and belief. I understand that inaccurate, misleading or untrue statements may
result in termination of employment and may also lead to legal & criminal prosecution
against me or any other party concerned.

Date -

Name - Page 6 of 6 Signature -