Employee Application Form Page 1 of 7
Employee Personal Information
Employee ID
Position Applied For
Photo
Date of Joining DD/MM/YYYY
Company Name
Division
Sub-Division
Location
Cost Center
Grade
Designation
Employee General Information
Salutation (Mr./Ms./Mrs./Dr./Ms.
Dr./Other if any)
Complete Name:
Last Name First Name Middle Name
Father’s / Husband’s Name
Mother’s Name
Spouse Name & Employment Details
Gender Mother Tongue
Date of Birth DD/MM/YYYY Birth Place
Blood Group State of Birth
Marital Status Date of Marriage DD/MM/YYYY
1
Employee Application Form Page 2 of 7
Country of Birth Nationality
Religion Cast Category
Primary Emergency Contact Relationship
Personal Contact No.
Personal E-mail ID.
Provident Fund No.
PAN
UAN
Aadhaar Number
Name as per the Aadhaar
Card
Sr. No. Languages Speak (Yes/No) Write (Yes/No) Read (Yes/No)
1
2
3
4
Family / Dependent Details
Relation Last Name First Name Gender Birth Date Age Birth Place Nationality
Father
Mother
Spouse
Brother
Sister
Child-1
Child-2
Child-3
2
Employee Application Form Page 3 of 7
Address Type
Permanent Address
C/o
House No. / Street No.
Address Line -2
City
District
State
Country
Postal Code
Present Address
C/o
House No. / Street No.
Address Line -2
City
District
State
Country
Postal Code
3
Employee Application Form Page 4 of 7
Qualification
Qualification SSC HSC Diploma / Graduation
Degree/Course Name
Institution Name
University Name
From Date
To Date
Specialization
Part Time / Full Time /
Correspondence
Percentage
Degree
Qualification Post-Graduation MBA PhD / Any others
Degree/Course Name
Institution Name
University Name
From Date
To Date
Specialization
Part Time / Full Time /
Correspondence
Percentage
Degree
4
Employee Application Form Page 5 of 7
Previous Employment Details
Employer Current Employer Last Employer 2nd Last Employer
Company Name
City
From Date
To Date
Sector
Department
CTC/Annual
Designation
Full Time / Part time /
Temporary
Reason for
Leaving
Employer 3rd Last Employer 4th Last Employer 5th Last Employer
Company Name
City
From Date
To Date
Sector
Department
CTC/Annual
Designation
Full Time / Part time /
Temporary
Reason for
Leaving
5
Employee Application Form Page 6 of 7
Present Salary Details (Rs.) (Per Annum)
Sr. No. Components Per Month Per Annum
1. Basic Allowance
2. HRA Allowance
3. Conveyance Allowance
4. Special Allowance
5. Medical Allowance
6. Other Allowances
7. LTA
8. Provident Fund
9. Superannuation
10. Gratuity
11. Medical Premium/benefits
12. Total Fixed CTC
13. Performance Incentive/Bonus
Total
Expected CTC (Annual)
Major Achievements
Sr. No. Remarks
6
Employee Application Form Page 7 of 7
Other Information
Are you related to any of our/group companies present employees / directors? (Yes/No):
If yes to whom?
Employee Name / Director Name Employee ID Relationship Designation
Have you ever been involved in court proceedings? Yes / No
If yes, please share details:
Do you suffer from any Physical Disability? (Yes/No):
If Yes, please mention:
Date Learned
Challenge Group
Degree of Challenge
Type of Challenge
Particulars of 2 persons, excluding relatives as references:
Reference 1: Reference 2:
Name: Name:
Occupations: Occupations:
Address: Address:
Contact No. Contact No.
Certified that the above information is true to the best of my knowledge, I understand that any false or
misinformation will automatically lead to disqualification of my candidature / termination of my employment.
Signature:
Date:
