Name (in block letters)
First Name Middle Name Last Name
Sex Male / Female
Date of Birth (dd/mm/yy) Age ____Yrs._____Months
Present Address / Permanent Address / Paste Your Photograph here
Residence Telephone No. / Mobile No. / Email id.
Contact No. in case of any emergency / Person to be contacted / Relation
Place of Birth / Nationality / Blood Group / Income Tax (PAN No.)
Height / Weight / Eyesight / Hearing / Disability/Handicap (if any)
cms / kgs
(Aided/Unaided) / (Aided/Unaided)

PLEASE TICK:

Languages known / Speak / Read / Write

EDUCATION :

Degree /Diploma / University /Institute / Year of Passing / Grade / Subject of
Specialization
TECHNICAL / COMPUTER QUALIFICATIONS
Degree /Diploma / University /Institute / Year of Passing / Grade / Subject of
Specialization
TRAININGS/SEMINARS ATTENDED
EXTRA CURRICULAR ACTIVITIES/HOBBIES
MEMBERSHIP WITH CLUBS / ASSOCIATIONS

Live with parents / Have you resided abroad?

Rented House

Live with Relatives Own House / Where? / When (Period)?
Passport No.:-

FAMILY DETAILS :

Marital Status / Marriage Date / Spouse’s Date of Birth
Father’s Name Father’s Occupation
Spouse’s Name Spouse’s Occupation
No. of Sisters ______No. of Brothers ______Children ______
Name of Child / Sex / Date Of Birth

EMPLOYMENT DETAILS:

  • Start with first employment, mention period of unemployment separately, promotion in the same
company is to be treated as a separate item.
Employer’s Name / Date of Joining
(dd/mm/yy) / Date of Leaving
(dd/mm/yy) / Position
held / Total Cost to
Company (p.a.) / Reasons for
leaving
Start / Last
Do you own a vehicle (Y / N)? If (Y), please specify (two / four-wheeler)
You may give any other information about yourself, your skill set that you may like us to note

REFERENCES:

Are you related to or known to any present or previous employee of this company? If so,
details below -
Name Department Designation Relationship

Other references (not relatives)

Name Occupation Address, phone no., email
1.
2.
I hereby certify that all information given above is true. I understand that, any incorrect
information given by me will make me liable to immediate dismissal. I agree to abide
by the rules and regulations of the company.
Date : ______
Signature

Page 1CONFIDENTIAL