CANDIDATE PARTICULARS FORM

Prolifics Proprietary and Confidential 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

CANDIDATE PARTICULARS FORM 

   

Please expand initials (Use Capital Letters Only)

First Name Middle Name Last Name
 

Permanent Address Mailing Address Present Address

Contact Tel. No. ( if any)

Tel. Tel. Alternate Tel.

ACADEMIC QUALIFICATIONS: (FT – Fulltime, PT – Part-time and C - Correspondence​)

School / College / FT / Month & year Degree / Class Main subjects
University PT / Diploma & %.
and address of college C ​# awarded
From To
Post Graduation

Graduation

PUC/ Equivalent Computers

 
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SSC/ Equivalent Mathematics,

Science,
Social Studies

Please explain​: (a) for any gap between academic courses and (b) if you have taken more time than the course
duration.

 
PREVIOUS EMPLOYMENT RECORD​ ​(​Do not give details of your present employment here)
Give full details of your previous employments in unbroken chronological order. Attach extra
sheet, if required. ​Please explain for gap (not covered by education / training).

Employer’s Name, Duration Last position Nature of duties Gross Reason for leaving
Address and phone no. (Month & Year) held Salary p.a.
**
From To Designation On Joining

On
Releving
From To Designation On Joining

On
Releving
From To Designation On Joining

On
Releving
From To Designation On Joining

On
Releving
From To Designation On Joining

On
Releving

PRESENT EMPLOYMENT
Name of the company & Address: Contact No :

Initial Position: Date of Joining:

A.S.O
Present Position: Whom do you report to:
A.S.O

 
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Organization Chart showing whom you report, who reports to you, who are your team members: (Please
mention the name / contact no/ Email id)-

ORGANISATION CHART-

 
Last Hike Received:

Received in the Year % Of Hike Effective Performance Rating

Of from

 
Have you applied for a position in this Company or any of our Group Companies before? If yes, 
please  
give details. 

Period of application Outcome

If you have any relatives / friends / acquaintances in this company or in any of our group 
companies working at present or in the past, please give details. 
 
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Name: Group Company: Relationship:

Give  2  references  under  whom  you  have  either  worked  /  received  education  or  who  knows  you 

professionally (other than your relatives) 

Names Position held & Address Years of

Organization acquaintance
I.

Tel: Off.
Tel: Res.
II.

Tel: Off.
Tel: Res.

Awards / Achievements or Special Comments:

Areas of Interest:
 
 
 
 
 
 
 
 
 
 
 
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Do you posses any technical certification/ training? (Specify):

Do you posses any Practical Training? (Specify)

Do you have a Bond with your current employer? If yes, please give details of the time period, 

amount and any other relevant details. 

What is the time required for joining, from the time of receiving an offer from Prolifics? 

 
Do you have any Job Offer from other organizations (specify, give details): 
1.  2. 
   
 
 
 

 
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I  certify  that,  facts  stated  in this application are true. I understand that any misinterpretation or 

suppression  of  material  information  will  render  me  liable  to  be  dismissed  by  the  Company.  I 

have  no  objection  to  your  inquiring  from  any  of  my  previous  employers  on  any  matters 

pertaining to me, if I join your Company. 

Date : Applicants Name:

Applicant’s Signature:

 
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