ITI LIMITED

(A Government of India Undertaking), Affix your self

NS Unit, BENGALURU – 560016 attested recent
color passport
EMPLOYMENT APPLICATION FORM size photograph
here
INSTRUCTIONS: [Do not staple]

a) All columns should be filled in BLOCK LETTERS

b) Incomplete applications/applications without enclosures will be rejected
Please tick whichever is applicable d)
Percentage of disability
e) Religion
1. RELATIVES IF ANY IN ITI
YES / NO
LIMITED
NAME & ST.NO. RELATION PLANT/ OFFICE
If YES, state his/her details

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2. ADDRESS
LOCAL: PERMANENT:

10. MOBILE NO:

(R) (O)
11. TELEPHONE NO WITH STD CODE

12. E-MAIL ID
READ WRITE SPEAK
13. LANGUAGES KNOWN: (HIGHLIGHT
MOTHER TONGUE)

14. ACADEMIC QUALIFICATIONS: (Starting from Matriculation)

 Whether
Ful
Duration
l
of
tim
th Month &
e Name of the Institution Class / Division obtaine
EXAMN PASSED e Branch/Discipline year of
co & University with % of marks
co passing
urs
ur
e
se
[Yes
/No]
SSLC/
Matriculation
PUC/12th standard

Degree (specify)

PG Degree
(specify)

Others (please
specify)

15. Are you employed in Govt/ PSU/Quasi Govt,if yes have you applied through proper channel.

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 -3-

16. EXPERIENCE: a) Start with current employment. Separate sheet may be enclosed as per the below format
Govt/CPSU/ Period Total Job
SPSU/ descr
Name & Address of
No Quasi/ Post held From To iption Pay Scale / Salary dr
the Employer yr mth
Pvt m/y m/y in
brief

b) SALARY DRAWN (please furnish details of all components like Basic, DA, HRA,CCA including Pay Scale etc)

17. DETAILS OF MEMBERSHIP OF PROFESSIONAL INSTITUTIONS

18. Brief sketch not exceeding 200 words about your achievements made in the present assignment: (separate sheet may be encl
as Annexure)

DECLARATION

I, the undersigned hereby certify that the information furnished above is true to the best of my knowledge and belief. In the event o
information being found incorrect / false, I am liable for such action as the Company may determine.

Place :……………………………….
…………………………………..
Date : ……………………………….. SIGNATURE OF THE
CANDIDATE