Doc.No.
CEPL/HR/REC/001/01
Chavare Engineering Pvt. Ltd.
Application Form
We thank you for envisaging interest in joining our
Organization and request you to:
1. Please complete the form in your own handwriting Affix a passport size
giving specific details. latest photograph.
2. Please do not leave blank spaces
3. Please add extra sheet wherever necessary
4. Please √ in the field wherever applicable
All the information will be treated as Confidential.
Position Applied For: _________________________________
_______________________________________________________________________
A. Personal Information:
1. Name: ________________ ____ ________________ ___ __________________
Surname First Name Middle Name
2. Local Address: __________________________________________________
__________________________________________________
__________________________________________________
3. Contact details: LL: _____________Cell: ___________ Mail Id: _______________
4. Permanent Address: _____________________________________________
_____________________________________________
5. Total Family Income: Rs. __________ per annum. 6. Pan No. :_______________
7. Type of Accommodation: Ownership / Rented / Company Quarter / Others
8. Date of Birth (DD MM YY):____________ 9. Pass Port No.:________________
10. Place of Birth: ____________ State: ______________________
11. Marital Status: Single / Married / Widow / Widower / Separated / Divorcee
12. Height in Cms: ______________ 13. Weight in Kgs: _______________
14. Blood Group: ______________
15. Emergency Contact, Name & Contact Details: _____________________________
Relation with Contact Person: ______________ LL: __________Cell No: ________
16. Driving License Number: _____________________________________________
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17. Languages Known: Speak Read Write
_______________ _____ _____ _____
_______________ _____ _____ _____
_______________ _____ _____ _____
_______________ _____ _____ _____
B. Family Information:
Sr Relationship Name Age Qualifications Occupation
. in
N Yrs
o
1 Father
2 Mother
3 Spouse
4 Child 1
5 Child 2
6 Brother /
Sister
7 Brother /
Sister
8
C. Other Information:
1. Current Extra Curricular activities / Hobbies / Interest: _____________________
________________________________________________________________
2. Please provide details of major illness / Accidents if any: ________________
________________________________________________________________
________________________________________________________________
3. Please provide detail if you were involved in any Civil / Criminal Case: ________
________________________________________________________________
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D. Qualification: (Please start with SSC onwards)
1. Educational:
S Name of Board / Period Qualification Year of % of
r. Institute University From To Passing Marks
N
o
1
2
3
4
5
6
2. Other Credentials:
A. Scholarships / Prizes / Awards if any: _____________________________
_____________________________________________________________
B. Publications if any: __________________________________________
__________________________________________________________
__________________________________________________________
C. Training Attended:
Sr. Details of Training Conducted by Duration
No.
1
2
3
4
5
D. Projects Handled: _____________________________________________
_____________________________________________________________
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E. Experience Details:
1. Employment Details:
(Please provide break up of existing salary)
S Name and Period Designation Major Gross Reason
r Address of From To Self Reporting Responsi Salary for
. Organization Officer bility Leaving
N
o
1
2. Organization Structure of last Employment:
Please illustrate the Organization Structure of your Present / Last Employment in terms
of immediate reporting relationship. ( Two levels above & below the position held by
you )
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3. Break up of Emoluments of Present Organization. (Notional Figures +
Quantified Amount of Facility)
Please Provide Monthly Details:
Ba DA HRA Conveyance Education Entertainment Incentive
sic Allowance Allowance Allowance
M LTA Bonus PF Gratuity Group Other Gross
ed Insurance Monthly
ic Income
al
5. Expected Gross Yearly Income (CTC): Rs. ___________________
6. PF & FPF Membership: Yes / No
If Yes, A. is it an exempted Fund: Yes / No
B. Exemption No. _____________
C. Please give your PF / FPF No. ___________________
7. Covered under ESI Scheme: Yes / No
If yes, please provide LP No. __________________
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F. General Information:
1. Have you applied to this company before? Yes / No If Yes then please provide the
Following details:
Position applied for ___________________ Date of application ___________
2. Are any of your relatives employed in this organization? Yes / No
If yes, please provide following details:
Name of the Relative __________________ Department ________________
3. Who referred you for this position? Please provide following details:
Name __________________ Contact No. _____________________
4. Reference: Please provide two references
Sr. Name Profession Address Contac No
No
.
1
5. If selected when you can join? Immediately / One week / One Month /
Three Months
G. Declaration:
The undersigned hereby declare that information and particulars furnished above are factual to
the best of my knowledge and belief. I further declare that if any of the above particulars or
information found by the company to be inaccurate or false whatsoever at any stage, my
appointment either as a probationer or thereafter as a permanent employee will stand vitiated
ab initio / cancelled.
Signature of applicant ________________ Date. ___________ Place ____________
H. For Office Use Only:
Position Considered for: _________________________
Signature of Appointing Authority. _________________ Date: ____________
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