The Sirpur Paper Mills Ltd.

SIRPUR KAGHAZNAGAR – 504 296 (A.P)

Dist. Adilabad

Cable: “SIRPAPER” Fax : (08738) 238642

Phone: (08738) 238044, 238045 (PBX) email :

APPLICATION FOR EMPLOYMENT

PART – I

1.  a) Post applied for ______

b) Job Code ______

2. Full Name ______

3. Father’s/

Husband’s Name______

4. Nationality______Whether SC/ST ______

(a) Religion ______(b) Caste ______

5. Full Address (a) Present ______

(b) Permanent ______

______

(c) Contact Phone No/Mobile ______(d) E-mail ID ______

6. Date of Birth______7. Age ______Years

8. Place of Birth ______9. Marital Status ______

10. Height ______CM 11. Weight ______Kgs.

12. Give details of your children and dependents in column below:

Sl.No. / Name / Sex / Age / Relationship / Present occupation if any
1
2
3
4
5
6

13. Have you/yours wife undergone Family Planning Operation? Yes/No.

14. Do you have any physical disability? If yes, give details______

______

______

15. Academic/Professional/Technical Qualifications (In chronological sequence beginning from school

Leaving Examination)

Examination passed / Year of passing / Name of the School/College/ Institution / Name of the University/ Board / % of Marks / Major Subjects studied

16. Distinction honors and awards (Academic, extra Curricular, community etc.)

Sl.No. / Distinction/Award / Given by / Year / Basis of selection

17. Please list the training and development programmes attended.

Sl.No. / Course/Training Programme / Conducted by / Duration / Year

18. Member ship of professional societies/institutes

Sl.No. / Name of Society/Institution / Status / Membership No..If any

.

19. Languages Known:

Language / Speak / Read / Write / Examination passed (if any)
Fair / Good / Fluent / Fair / Good / Fluent / Fair / Good / Fluent

20. Have you undergone any Apprentices Training: YES/NO

If Yes:

Organization in which Apprenticeship done / Duration / Paid or Unpaid

PART II

21.  Record of Experience (from the date of leaving education upto –date)

Name & Full address of the Employer & nature of Industry/Business/Annual Sales/Employ ment / Period / Position held / Length of service Yrs/Months / Major Responsibilities / Gross Remuneration / Reason for leaving
From To / At Start At End / Starting / Final
a) Present:
b). Last:
c). 2nd Last:
d) 3rd Last:

PART –III

22. Please outline your present job responsibilities and attach the existing organization chart showing your relationship with superiors Peers & Subordinates.

23.  Are you related to any of the Directors or any employee working in the company/member units of our organization? If yes, give details:

Name of the relative / Name of the Unit / Department / Relationship

24. Give three personal references (other than relatives)

Sl.No / Name and address / Telephone No. / Position / How long known
1
2
3

25. Family background give brief information regarding Father, Mother, Brothers & Sisters including their occupation (special mention should be made of the applicant’s financial dependence on dependence on family if any)

26  Hobbies: extra curricular / leisure activities, social work etc.

27. Are you a member of (If yes, give details there of including membership No.)

(a). Provident Fund ______

(b). Family Pension Fund Scheme ______

(c). ESI Scheme ______

(d). Superannuation Scheme ______

(e). Employment Exchange Reg. No.______District ______

28. Have your ever been convicted: If yes, please give details:

29. Name & Address of next of kin ______

(Who should be contacted in case of emergency) ______

______Telephone No.______

30. Describe your significant achievements and your evaluation as to why you consider yourself suitable for this post.

______

______

31. Present Employer & Address:

Salary Particulars:

Sl.No. Details of Emoluments / Per Month [R.s] / Expected salary per month
01. Salary : Basic
02. D.A.
03. V.D.A
04. H.R.A.
05. LTA/LTC
06. ESI/Medical Reimbursement
07. Conveyance Allowance
08. Education Allowance

09. Soft. Furnishing
10. Production Bonus
11. Any other Allowance
Sub Total (i)
12. P.F. Contribution
13. Superannuation
14. Gratuity
15. Annual Bonus / Exgratia
16. Any other benefit
Sub Total (ii)
Grand Total (i) + (ii)
17. HRA / Accommodation

32. Expected Gross Salary ______

33. How much time would you require to join, if selected ______

I hereby declare that the information furnished above are True and Correct to best of my knowledge.

Place:

Date: Applicant’s Signature.

Remarks the Interview Committee:

Date: