CONSUMER EDUCATION & RESEARCH CENTRE

`SURAKSHA SANKOOL, THALTEJ, SARKHEJ-GANDHINAGAR HIGHWAY, AHMEDABAD 380 054

Phone : 079-27438752, 53, 54 Fax : 079-27489947 E-mail : cerc@wilnetonline.net

APPLICATION WITH BIODATA

Please clip a
copy of your recent

POST APPLIED FOR __________________________

passport size
photograph

1.

PERSONAL INFORMATION

A)

Full Name :
(In block letters)
________________________________________________________
(SURNAME)
(NAME)
(MIDDLE NAME)

B)

Present Address : ____________________________________________________

here

____________________________________________________
____________________________________________________
____________________________________________________
____________________________________________________
Permanent Address : __________________________________________________
__________________________________________________
__________________________________________________
__________________________________________________
__________________________________________________
C)

Phone : (O) _____________________________ (R) _________________________

D)

Date of Birth ____________________ State of Domicile ______________________

E)

Height : __________________ Weight : ______________ Specs : ______________

(Cm)
(Kg)
No.(-) (+)

F)

Disability
or
Chronic Disease

__________________________________________________
__________________________________________________

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__________________________________________________
G)
H)

Marital Status :
(Single / Married) __________________________________________________
For Female Employees Please indicate if on family way
Yes / No.

I)

if yes,

Date : ________________________

Name of Husband / Wife

Age
Occupation
Employers
or
Address
Father / Guardian
_____________________ ________ ____________ _______________________
_______________________
_______________________

J)

No. of Children and Age : _______________________________________________

K)

Resident Parents / In laws

& their age : __________________________________________________________

L)

Language known (Please Tick)

LANGUAGE

Speak

Read

Write

ENGLISH
GUJARATI
HINDI

2.

ACADEMIC PURSUITS :
Degree /
Diploma

Name and
Place of the
Institute

Year
of
passing

i)
ii)
iii)
iv)
v)

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Principal
subject

Medium of
instruction

Div.%

Extra Curricular Academic Activities

Academic Awards :

3.

PROFESSIONAL EXPERIENCE :
(Last service should be written first)

Employers
name

Position
held

Period
From To

Initial
Salary Drawn
Basic Total

Last
Salary Drawn
Basic Total

A.
B.
C.
D.
E.

4.

PROJECT HANDELED :

5.

DESCRIBE PRESENT JOB & PAST EXPERIENCE :

Kindly describe your present job
In details and previous in brief

6.

GROSS SALARY EXPECTED :

7.

GENERAL INFORMATION :

Supervisors Name
& Designation

Ambition in Life :

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Reason
for
leaving

Involvement in Social Development

Special Interest in Consumerism

Hobbies
Sports

8.

REFERENCES :
Name

Designation

Address & Phone Nos.

1) ________________________

______________

_________________________

________________________

______________

_________________________

2) ________________________

______________

_________________________

________________________

______________

_________________________

DECLARATION

I certify that the foregoing information is correct and complete to the best of my
knowledge. If I am found, at any time to have given any false details against any of the
above particulars, my appointment shall be liable to summery termination. Any
advantage derived by me during the tenure of my office, by reason of false or
misleading information, shall be refunded to the centre, without prejudice to other rights
and remedies that the centre may have against me.

Place :
Date :

Signature of Applicant

* Attach seperate sheet, if required.

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