APPLICATION FORM

POSITION :

A. PERSONAL DATA:

1. Name in full (Block letters)

PATIL ANIKET RAMCHANDRA

2 Present Address (Surname) (Name) (Middle Name)

Survey No House No A37, WalhekarWadi Road, Chinchwad Pune.

3. Permanent Address

At/Post. Mandur. Tel – Shirala. Dist – Sangli 415415

4. Telephone Nos.: Office: Residence:

Cell: 7758068785 E-mail Id: a n i k e t p a t i l 6 6 9 6 @ g m a i l . c o m

5. Date of Birth - 27 July 2001. Place of Birth - Mandur Nationality - Indian Region - Hindu

Marital Status: Unmarried Date of Marriage: / / Blood Group – B+

6. Caste / Category (Tick whichever is applicable) Sub Caste - Maratha (If any)

General OBC SC ST

7. Languages known (Please put a tick mark in the relevant boxes) :

Language Speak Read Write Remarks Reg. Fluency

English Yes Yes Yes
Hindi Yes Yes Yes
Marathi Yes Yes Yes

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B. EDUCATION :
8. Start from highest degree please (Please specify part time courses with a *):

1.1 Period Name of the School/ Degree/ Specialization Marks Class/

From To University/Board Diploma Obtained Rank
[%]
2020 2023 Nanasaheb Mahadik B.Tech 80%
Collage Of Engineering,
Peth.

Dr. Babasaheb
technological University,
2017 2020 Nanasaheb mahadik Diploma 84 %
polytechnic institute, Peth

2016 2017 New English school SSC 81 %

warnavati

9. Please specify if you have participated in any extrac urricular activities in School or College: Any posi-
tion/offices held

10. Are you a member of any Professional Association or Body? If so, give details:

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C. EMPLOYMENT:

11. Please specify the current employment first, followed by the previous employer and so on : (Use separate lines
for significantly different positions in the same organization)

Name & Company’s Duration Designation Reasons for Name &

Address of the turnover/ leaving Designation of
Employer Your person reporting to
Division’s
turnover

From To
Date Date

(Please attach extra sheets to provide this information if required)

12. Specify your current position in your organization chart. Indicate 2 levels above and below yourself, besides
peer level (pls mention N.A.)

(Self)

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13. Please indicate the functions handled by you?

In your present job:

In your previous job/s:

14. Specify your career achievements till date quantifying benefits to employer wherever possible: (Attach addnl.
sheets if required)

15. Any other abilities you would like to mention

GENERAL INFORMATION:

16. Please list your hobbies and any specific interests:

1. Cooking
2. Outdoor games
3. Listening music

17. Passport Details: No. NO

Dated. _________ Place of Issue: ____________ Dated from: __________ Dated till: _________

18. Have you ever been convicted / involved in any criminal litigation?

NO

19. Have you previously applied to this company or have been interviewed? If yes, when and for which position?

NO

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Please detail your existing CTC; please attach Xerox copy of your last 3 pay slip & official documents mentioning
CTC:

Additional sheet if necessary:

Salary Head Per Month [ INR ] Per Annum [ INR ]

TOTAL

19. Minimum Expected Salary:

20. Notice period required to join? Minimum:

REFERENCES:
21. Please give the names of two persons who know you but are not your relatives. The company may refer to
these persons;

1. Name & Address:

Phone: (Office) Cell:
2. Name & Address
Phone: (Office) Cell:

I hereby certify that the above statements are true and correct to the best of my knowledge and belief.

I understand and fully agree that any statements made herein which are found to be erroneous or otherwise
incorrect, which tend to mislead the Company will be sufficient cause for the Company to terminate my services
from the Company at any time during my employment.

Signature:__ Aniket Ramchandra Patil Date: 12/01/2024

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Revision History Table

Revision Written By Reviewed By Approved By Issue Date Change History

000 S. Lingal R Gupta R Gupta 01.01.2018 Initial issue

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