APPLICATION FORM FOR TRAINEES (MT & GET)

Preferred Location:

UP - Gorakhpur, Sant Kabir Nagar, & Kushinagar

AFFIX
UP - Kanpur, Etawah, & Auraiya LATEST PASSPORT
UP – Moradabad SIZE
UP – Mathura PHOTOGRAPH
UP – Azamgarh, Mau & Balia
UP – Barabanki and Gonda
UP – Basti & Ambedkarnagar
Punjab - Patiala, Sangrur, & SAS Nagar (Mohali)
Rajasthan -Jaipur, Kota & Alwar
Rajasthan – Kota (Ex.), Baran & Chittorgarh
Rajasthan – Dholpur
Gujarat – Junagadh, Ahmedabad
Maharashtra - Pune (Ex).
Telangana - Sangareddy, Medak & Siddipet
Tamil Nadu – Chennai & Tiruvallur
Tamil Nādu - Karaikal & Nagapattinam

(Note: Mentioned number (1 -14) in terms of your preference. 1 being your 1st preference)

Applicant's Name in full: __________________________________________________

(Surname) (Name) (Father's Name)
Present ________________________________________________________
Address:
_________________________________________________________
Permanent Address: _______________________________________________________

___________________________________________________
Native Place: ______________________
E-mail ID: _______________________
Mobile No.: ____________________ Emergency Contact No: _________________
Date of Birth: ________________ Age: ________ Sex: Male/Female: _________

 FAMILY MEMBERS DETAILS:

Annual
Health
Relationship Name Age Profession Income
History
(LPA)
Father
Mother
Brother 1
Brother 2
Sister 1
Sister 2
1
 QUALIFICATIONS (SSC ONWARDS):
Sr. Name of the Diploma Name of the Major Marks % Class
No. Exam Passed or Degree Institution & Subjects or
& Year Course University (E / M / Obtai Out Grade
I&C) -ned of

1.
2.
3.
4.

SEMESTERWISE MARKS
Name : _____________________________________________
Discipline : _____________________________________________
Name of Institute : _____________________________________________

Semester Year of Exam Mark Obtained Mark out of Remarks

TOTAL
Any Gap during Education. If Yes, please mention the year and the reason for the gap:
___________________________________________________________________________

Details of Apprenticeship done in any Company/work experience if any:

__________________________________________________________________________

_______________________________________________________________________
 MEDICAL HISTORY:
 Have you suffered any major ailment/accident? Or Have you undergone any major
surgery or are you undergoing any treatment ( Yes / No)
If yes, please give details_________________________________________________
___________________________________________________________________
___________________________________________________________________

2
  Are there any hereditary disease in the family (Yes / No). If yes, give details.
__________________________________________________________________
___________________________________________________________________

 Do you have any physical limitation or have any irreversible medical conditions
(Yes / No)
___________________________________________________________________
___________________________________________________________________
 OTHER DETAILS:

 Have you ever been involved in any misconduct or disciplinary case or criminal case?
(Yes / No)
___________________________________________________________________
___________________________________________________________________

 Do you have any relatives who are working or have worked in the past with Torrent
Group?
If yes, please specify the details: __________________________________________

DECLARATION:
I hereby declare that all the details furnished above are true to the best of my knowledge and
belief. I further declare that my appointment may be cancelled, at any stage, if I am found
ineligible and/or the information provided by me is found to be incorrect.

Date :
Place : (Signature of Applicant)