XYZ LTD

Application for Employment (Should be filled by candidate only)

Instruction to fill in the Form: Affix a recent

o Please fill in the form in BLOCK LETTERS only passport size
o All the Fields must be filled completely photograph
o Please tick the appropriate box as applicable
o Please attach a copy of your CV/Resume along with this form
o Please attach supportive documents for the details furnished

Position Applied for

Location/HQ & State Ready to Relocate? Yes/No
Total number of Years of Relevant Experience
Present Salary Expected Salary
How did you get the
Recruitment Company Online Job
information about this Reference Others
Ad Website Portals
Opening?

PERSONAL DETAILS
Title Mr Ms Mrs
Name In full
Sir Name
Date Of Birth (DD/MM/YYYY) & Age
Father’s/Husband’s/Guardian’s Name
Religion and Nationality
Marital Status Single Married Divorced
Permanent Correspondence

Address (With PIN Code)

Landline(With STD Code) Mobile No’s

Telephone No’s (For both Permanent and i) i)
Correspondence addresses) ii) ii)
i)
Active Email ID’s
ii)

ADHAAR CARD Number/PASSPORT Number

PAN Number
Details of Valid Driving License (Applicable
for Sales Staff)
Do you own a two wheeler? If yes, details
EPF Membership ESIC IP Number Others, if any
Statutory Information

Have you ever employed at XYZ Ltd? Yes No Details, if yes

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Details of Education
Course/Degree/ Diploma (Details Academic Years
of SSC(X Class), Inter, Graduation, % of Class/
Board/University
Post Graduation, Diploma, Begin From To Marks Grade
with Highest)

DETAILS OF PROFESSIONAL TRAIANING OBTAINED

Name of the Program Description Institute Purpose

LANGUAGES KNOWN (TICK THE APPROPRIATE ONE)

OTHERS – I OTHERS – II OTHERS – III
ENGLISH HINDI
( ) ( )

Read Write Speak Read Write Speak Read Write Speak Read Write Speak Read Write Speak

DETAILS OF CURRENT EMPLOYMENT

Period Total
Designation Organization Location Reason for Leaving
From To Duration

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DETAILS OF PREVIOUS EMPLOYMENT (Begin with the recent employment)

Period
Total Reason for
Designation Organization Location
Duration Leaving
From To

DETAILS OF YOUR SALARY DURING THE LAST 3 EMPLOYEMENTS (Write in reverse

chronological order)
Other
Name of the Organization Salary Allowances, CTC/Gross
Designation Salary
if any

HIGHLIGHTS OF YOUR CAREER (ACADEMIC OR PROFESSIONAL)

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INFORMATION ON YOUR HEALTH

Blood Group and Rh Factor

Details of Physical Disabilities, if any

Details of Major illness, chronic Diseases, Accidents,

Surgeries , etc

Allergic to

DETAILS OF CRIMINAL RECORD/ POLICE CASES/ COURT CASES/ FIRs, IF ANY. IF

THERE IS NOTHING, PLEASE MENTION “ NO”

DETAILS OF FAMILY MEMBERS

Name Date of Birth & Age Relationship Occupation

IN CASE OF EMERGENCY, PERSON/S TO BE CONTACTED

Name Relationship Address Contact Number/s

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REFERENCES (1 from Personal front+ 1 from Professional front)
Known for
Name Relationship Occupation No. of Years Address & Contact Number/s

Other information

I, declare that the particulars given above are correct and true to the best of my knowledge
and belief and no attempt has been made by me to Conceal or withhold pertinent
information, which you are at liberty to verify at any time. I also understand that any
misrepresentation of facts in the application is sufficient cause for termination of my services,
if appointed.

Station:
Date: Signature:
( )

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