Attach Recent

Passport size
Photograph.

APPLICATION FORM
Name: Gender : Male Female

Date of Birth : Age : Mobile No:

Emergency Contact Person:
Emergency Contact Number: Email Id:

Present Address: Permanent Address:

FAMILY BACKGROUND:
Marital Status: Married Single Divorcee
Housing: Living with parents ( ) Own house ( ) Rental ( ) Company ( )

Particulars of the Family

Relation Name Age Qualification Occupation Employer

Father

Mother

(Brother/Sister)

Spouse

Children

LANGUAGES KNOWN (Underline Mother Tongue)

Language Read Write Speak

HEALTH DETAILS
 Do you suffer from any physical disabilities or require special assistance?
Yes No
 Do you have any major/minor surgery?
Yes No
If yes, to any of the above, please specify: _________________________________________________

EDUCATIONAL BACKGROUND
(Chronological order starting with SSC/Std X. Indicate whether F-Full time, P-Part time or C-Correspondence)
Page 1 of 4
 Completion Grade F/
Qualification Institution University / Board
MM & YY % P/C

CA QUALIFIED / SEMI QUALIFIED

Completion No of
Qualification Institute Grade %
MM & YY Attempts
CPT

PCC/IPCC-Group 1

PCC/IPCC-Group 2

FINAL-Group 1

FINAL-Group 2

PROFESSIONAL QUALIFICATION (Eg :- CS, ICWA, CFA, MBA/MMS, PGDBM or any other relevant qualification)

Month & Year of

Grade No of
Qualification Institute Completion
% Attempts

PORFESSIONAL CERTIFICATIONS (Eg :- CISA, CIA, DISA, SAP, ORACLE or any other relevant certification)

Month & Year of

Grade No of
Qualification Institute Completion
% Attempts

EMPLOYMENT DETAILS (Starting from Present)

Page 2 of 4
 From To
(CTC)
Organization Designation DD/MM/ DD/MM/ Reason for Leaving
(P.A)
YY YY

Draw an organization chart to show who is responsible to you and to whom are you responsible to,
in your present/last job, as well as your relationship with peers.

Page 3 of 4
 REFERENCES

Please list any four professional references (preferred those whom you have reported to) from your
current/past company excluding relatives
Name Designation Organization Contact No

References from Aneja Associates (if any)

Name Position Contact No Relationship

**Reason for considering a change in employment: ____________________________________________

_________________________________________________________________________________________

Present CTC / Salary : ___________________p.a. Expected CTC / Salary : __________________p.a.

Notice Period required to be Given: ____________________no of Days

APPLICANT’S DECLARATION
 I hereby, declare that the particulars given in this form are correct to the best of my knowledge. No facts have
been suppressed or held back. I clearly understand that if any particular is found to be incorrect or facts found
to be held back, I shall be liable to be discharged without notice or any obligation on the part of Aneja
Associates, Mumbai.
 " I further declare that I was/am not involved in any criminal case and/or no such case is pending against me
"

Date: __________ Place: ______________

Applicant's Signature:

Page 4 of 4