Application for Employment s33

APPLICATION FOR EMPLOYMENT

(Please read the notes below carefully before filling in the form) This form is to be filled and submitted in by the applicant electronically only. Original Documents past and present to be produced during interview. Do not leave any places blank. Write NA in case not applicable.

Post applied for Full Name

2. Present Address (Where communication may be sent) 3.Permanent Address Please affix digital photo 4.a. e-mail b. Mobile No.

Personal Details : a. Date of Birth 6. Whether the applicant b. Place of Birth has defective sight, Age hearing speech or other d. Caste handicap? (Give details e. Domicile if he / she wears f. Height (cm) glasses) g. Weight (kg) h. Blood Group 7.a. Mother tongue b. Language known Read Write Speak Please (√ ) mark i. Gujarati ii. Hindi iii. English iv. If any other please mention 8.a. Whether Married  B. If married, No. of Married or Single? children, if any, with Unmarried  their age.

9. Education / Qualification : Particular of each examination Passed (Starting from 10th) Result ( to If any Name of Name of mention Pass academic School or Grade or Degree / Year of passing (Class) / Fail / Prize(s)and College / Board Percentage Diploma ATKT or Medal(s)achiev /University Backlog) ed

Application Form Page 1 10. Extra activities or hobbies

11. Extracurricular activities: a. Any special training taken

b. Participate in any seminar

c. Participated in any academic discussion

d. Presented any Research Paper (s)

12. Have you ever visited overseas? If so, give details with passport No. and validity if any.

13. Membership of any Institute / Club Details : Sr.No Level of Membership Key activity of Institute Date obtained . member No. Institute

Family Details : Name of Family Name of the organization Sr.No. Age Relation Occupation Member whether servicing 1

Details of Dependents : Remarks (Housewife / Sr.No. Name Relation Age Student / Retired)

Application Form Page 2 16. Parents Status : Sr.No Parents Name Live Decease Education d 1 Father 2 Mother 17. Give the name of relatives & friends. If any, who are serving in this organization currently or in past. Sr.No Name Relation Mobile No. 18. Are you a member of . Employee  Yes No 1 Provident Fund? (If, Yes mention Number : 2 the full number)

19. Particulars of applicant’s previous and present employment, if any Total Nature of Total Reason Name and Sr. Name of No. Designation work & Salary for designation of No. Organization of responsibility gross (PM) Leaving next superior Years

20. Are you currently studying if yes give details :

21. Do you wish to pursue study after taking up the job? If yes, give details :

22. Are you willing to travel :Yes No

23. Whether you have any habits like smoking, chewing pan, Tobacco, Masala? Yes /No

24. Have you ever been convicted of a crime? Yes No

If Yes ,Please describe :

25. Have you ever applied for any post with this organization, Yes No If Yes, when in the past & with what result?

26. References : Name Address Contact No E-Mail ID Occupation

Application Form Page 3 27. Your area of interest: 28. Are you prepared to sign a service agreement for three (03) years? 29. Have you suffered from any serious illness? 30. Your key job-related skills relevant to this type of work, and give indication of how you believe your background, experience and career ambitions will fit this role.

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I declare that the information given above is true and if found wrong during my tenure if employed will result in summary dismissal.

DO NOT LEAVE ANY SPACES BLANK.

Application Form Page 4