GyanSamhita

PERSONAL HISTORY RECORD

Name (Mr./Ms.)
Surname First name Middle name

Date of Birth Age

Place of Birth
Affix passport size
photograph
Nationality

Marital status

Contact Tel: (Off) (Res) E Mail address

Passport details
Passport No. Place of issue Date of issue Valid till

Address
Address for correspondence Permanent Address

Tel No. Tel No.

Email Email

Family details
Name Occupation

Father

Mother

Spouse

Children

Educational qualifications (Start with Secondary School Examination)

Degree/ Name of institution and Period % Score
Specialisation
Title place From To / CGPA

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Training Courses & On the job Training Undergone:
Course Period Institution

Interests & Pursuits

Employment Details (Starting with the current Employer)

Period
Designation on
From To Name of the Organisation Reason for leaving
Joining Leaving
MM/YY MM/YY

What do you regard as significant achievements in your professional career?

Please state briefly your short-term and long-term career objectives as also your immediate
plans towards attaining them

What are the values and beliefs that have guided your life so far and how do you see them
influencing your future?

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References (1) Name and address of your current supervisor or previous supervisor
(2) Names and addresses of two persons other than relatives who know you closely to whom we
may write for reference.

Name & Tel. No Res./Off

Occupation Email Address

Other Details:

Yes No
Do you have any relatives / friends working with us. If yes, please specify
1
name(s): Mr./Ms.
Are you willing to relocate, If yes, only within India Only Abroad Both
2
In India my preferences are Hyderabad Open
Have you been interviewed earlier?
3
If YES, specify the date / /
Do you have any handicaps, physical or otherwise? If YES, please give
4
details :
Have you suffered from any major illness or undergone any surgery in the
5 past 3 years? If YES, please give details:

How did you know about GYTECHS? (Website/Newspaper/Consultancy)

6 Please specify :

Details of Joining

Notice period required by current employer

Time required to join us if selected

Any other information that you would like to

provide

Introduced by if applicable

Declaration:I hereby declare that all the foregoing information is true to the best of my knowledge
and that any misrepresentation by me in this application will disqualify my candidature and
subsequent employment.

Signature of Applicant ___________________________ Date ___________

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Salary Details (Current job/last job).

Rs. Ps. Taxable (T) / Non

Monthly
Taxable (NT)
1 Basic

2 HRA

3 Conveyance
Other Allowances
/Reimbursements please specify
4

Total Monthly (A)

Annual Salary (Total of items Nos.
1 to 6) A X 12 = B
Annual Benefits
7 Provident
Fund
8 LTA
9 Superannua
tion
10 Medical

11 Bonus
Other Annual Benefits (Please
specify)
12

13

14
Total (C)
(Total of item nos. 7 to 14)
ANNUAL GROSS = B + C

Any other Entitlements / Perks / Loans / Stock Options, etc.

I will produce whatever proof may be necessary regarding my salary details mentioned above.

Salary Expected (CTC): Rs.

Name:

Signature: Date:

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