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CONFIDENTIALXXXXXXXXXXXXXXXXXXXXXXXXXEMPLOYMENT APPLICATION / PERSONAL PROFILEPost Applied for :Name : Emp.No :.Designation :. Dept :Affix PhotoI. Personal:1. Date of Birth: Place of Birth: 2. Religion: Caste / Community:3. Nationality: Sex: Blood Group:.4. Address for CommunicationPhone No.Permanent AddressPhone No.5. Languages Known (Please tick appropriate column) Read Write Speaki. (Mother Tongue). iiiiiivv.6. Presently your house : Own House Rented House7. Do you own, in youre your name / spouse name House site House Landed properties No 8. In case of emergency contact Name.RelationshipTel No 9. Your Bank Account: PAN No:. Bank Name.Branch.Account No 10. Do you know driving: Two Wheeler Four Wheeler None If yes, driving Licence No.Valid up to11. Do you own: Two Wheeler Four Wheeler None 12. Do you have a Passport:If yes, Passport NoValid upto.II. Health History:1. Your blood group : .2. Any Known allergies :.3. Do your wear Spectacles : Yes No If yes, What power : right eye Left eye4. Do you suffer from Respiratory Disorder Heart Disease Blood Pressure Diabetes Asthma Tuberculosis Others Specify: 5. Have you suffered any aliments in the past? Give details. Malaria Jaundice Hernia Piles Liver ailments Back Pain Others6. Have you had any accident in the past? 7. Have you undergone any surgery earlier?.8. Are you in the habit of smoking? Yes NoIf yes , how many cigarettes a day.nos. 9. Do you have the habit of chewing? Tobacco Pan No10. Do you consume liquor? Yes No Daily Weekly Twice a month Once in a month Special Occasions Occasionally 11. Do you exercise? Jogging Running Gym Walking Others (Specify).III. Family Background: 12. Whether married? Yes No If yes, furnish date of marriage :.FAMILY BACKGROUNDNameDate of BirthQualificationOccupationDependanceYes / NoSpouseChildrenIV. Educational History: (Starting from 10th Std.)Name of the InstitutionFromToExamPassedSpecial Subjects% of marksTraining Attended:V.Employment HistoryName &Address ofEmployerFrom ToMonth /YearDept /DesignationFunction / DutiesGross SalaryReason forLeavingI. Previous Experience:Additional Information On your Present / Latest Employment:Appointment DtReporting toYour ReporteesAnnual Sales turnoverStrength in Nos.(Per mensom)BasicDAH.R.AConveyanceOther allowanceSpecifyTotal per monthTotal per annum(A)(Per annum)LTAEducationalBonusMedicalOther allowanceSpecifyTotal per annum (B)Other Benefits(per annum)EPFGratuitySuperannuationOthers Total per annum(C) Gross per annum(A+B+C)Other Information: 13. Have you applied to /interviewed by us in the past? Yes No If yes, please state position applied for. Interviewed on.14. Please outline your present job responsibilities:15. Salary Expected:16.How soon would you been able to join us?17.Do you have any relatives employed in this company? If yes, give details:18. How did you get to know about the vacancy?19. Have you ever been convicted under any court of law? If yes, furnish details:20. Is there any Civil / Criminal proceedings pending against you in any court of law?References (No relative please)1.2.Name and Address of person to be contacted in case of Emergency:1.2.Your extra curricular activities, if any please specify Playing Games ( Specify). Cinema TV Reading Books Listening to Music Stamp Collections Social service Others. Declaration: I hereby affirm that the foregoing statement and answer to questions are true to the best of my knowledge and belief and without consequential omissions of any kind whatsoever and understand that any wrong st
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