Prospective Employee Details

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I hereby declare that the information provided herein is true to the best of my knowledge. Any misrepresentation
by me will lead to disqualification of my candidature or termination of employment without notice.I also authorize
Concentrix to send job\recruitment related notifications & updates on my contact number(s) and email updated with
Concentrix.
To be filled by the candidate in CAPITAL LETTERS only. Please do not leave any field blank.
PERSONAL DETAILS
First Name S P A N D A N A
Middle Name
Last Name G
Date of Birth 09 05 2002 Gender Male ☐ Female ☑ Others ☐
(DD MM YYYY)
Contact No. 8 2 1 7 5 1 9 5 8 7
Email ID SPANDANAGOPAL09@GMAIL.COM
Father's Name SPANDANA GOPAL
Present Address 449/1 3RD MAIN ROAD, VR PURAM, PG HALLI

City BENGALURU State : KARNATAKA Pin Code 5 6 0 0 0 3

HIGHEST
Under Graduate ☐ Graduate ☑ Diploma ☐ Post Graduate ☐ Result: Pass ☑ Awaited ☐
EDUCATION
From TO Degree/ Diploma / Name Degree/ Diploma / Certificate Name of the
(YYYY) (YYYY) Certificate Board/University Name Institution/School/College
MES COLLEGE OF ARTS
2020 2023 Graduate Bachelor of Commerce Bengaluru City University
COMMERCE AND SCIENCE

Foreign Language Diploma /

Certificate Course
WORK EXPERIENCE DETAILS (Start from most recent job) Fresher ☐ Experienced ☑
From To Annual
Name of Organization Designation at the
Emp Id Salary
DD MM YY DD MM YY (Branch/Location) time of Leaving
(CTC)

03 04 23 31 10 23 SaiShub tour's CRM SST0011 300000

I authorize, Concentrix or its 3rd party agency to use this for verification purpose with concerned authorities. I understand and
agree that Concentrix holds the right to conduct drug test & background check on my professional, educational and financial
background through independent sources. In case background check is negative/ drug test is positive, Concentrix to withdraw
the offer or terminate my employment with immediate effect. On joining I will submit authentic copies of all certificates,
testimonials to support the details mentioned in the form.
Applicant's Signature Date (DD/MM/YY): 21/11/2023
CNX/REC/ART/AGHR/PED/5.2
OTHER DETAILS
Marital Status SINGLE Aadhaar Number 4 9 1 4 8 7 7 1 8 3 8 2
Nationality INDIAN
SOURCE OF APPLICATION (Please tick mark the appropriate box)
Employee Job Social CNX
Agency ☐ ☑ Portal ☐ Advertisement ☐ Campus ☐ Network ☐ ☐ Others ☐
Referral Website
Agency/Referee/Portal/Social BHARATH K
Network Name
Emp ID/Candidate ID 1 0 0 6 4 5 3 9 6

Relocation (If Applicable) From To

Do you have UAN / EPF Account Number? Yes ☑ No ☐

Physically Challenged Yes ☐ No ☑ If yes, please submit supporting documents on Onboarding day

Have you ever worked with Concentrix / IBM Daksh / Yes ☐ No ☑ If yes,kindly share Employee ID:
Daksh / Minacs/ Convergys?
In case you have ever worked in / for Concentrix while being
employed by a vendor/consultant providing services to Date of Joining Last Working Day
Concentrix, please specify duration :

Applicant's Signature Date (DD/MM/YY): 21/11/2023

CNX/REC/ART/AGHR/PED/5.2

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