HUMAN RESOURCES DEPARTMENT

CORPORATE OFFICE: BANGALORE

Application for the post of …………………………………. (Mention

the post applied for)

1. FULL NAME IN BLOCK LETTERS:

2. ADDRESS FOR CORRESPONDENCE:

District:
State:
Pin Code:

3.. DATE OF BIRTH: DD MM YY

AGE (As on 01.04.2019): __________ Years

4. CONTACT DETAILS (Mandatory):

STD Code No. Telephone No. Mobile No.

E- Mail Address

Alternate Number:

5. INDICATE BY  MARK IN APPROPRIATE BOX:

GENDER: MALE FEMALE

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6. INDICATE BY  MARK IN APPROPRIATE BOX:

CATEGORY: SC , ST , OBC , EWS

7. INDICATE BY  MARK IN APPROPRIATE BOX:

Nature of Disability: OC , VI , HI , ID

8. PERMANENT ADDRESS:

District:
State:
Pin Code:

9.. EDUCATIONAL / PROFESSIONAL QUALIFICATIONS:

Educational Subjects studied/ Year of % of
Board / University
Qualification Specialization passing marks

Graduation
(Specify)

Post graduation
(Specify)

Other professional
Qualifications/
Certifications, if
any

10. PRESENT EMPLOYMENT:

Name of the current employer

Working with current employer since

Rank & Designation of current

employment

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11. POST QUALIFICATION EMPLOYMENT /WORK EXPERIENCE DETAILS: as on
01.04.2019

Name of the Years of

Total period of
Employer/Address Service
Designation Service Reason for
of the Employer & YY/MM
& rank if any Leaving
nature of
Employment From To

Total experience

12. In the Event of Selection:

i) Notice period required to be served to get yourself relieved from the present
Employer (in Months):

DATE:

PLACE: SIGNATURE OF THE APPLICANT

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