EMPLOYMENT APPLICATION FORM
POST APPLIED FOR:
FULL NAME IN BLOCK LETTERS
(LAST) (FIRST) (MIDDLE) PLEASE AFFIX
YOUR RECENT
PASSPORT SIZE
PRESENT HOME MAILING ADDRESS: PHOTOGRAPH
PIN CODE
TELEPHONE (With Code) CELL:
E-MAIL : BIRTH DATE [DD/MM/YYYY]
PERMANENT HOME MAILING ADDRESS:
AGE (YRS)
PIN CODE BIRTH PLACE
TELEPHONE (With Code) CELL:
MARRIAGE DATE
GENDER MARITAL STATUS NATIVE STATE RELIGION NATIONALITY STATE OF DOMICILE
(If Married)
PERSONAL DATA
LANGUAGES KNOWN (Including Foreign) SPEAK READ WRITE PASSPORT NO.
PAN NO
AADHAR CARD NO
UAN NO
EPF NO
EPS NO
DETAILS OF FAMILY MEMBERS (parents, spouse, children, siblings & any other dependents excluding self)
NAME RELATIONSHIP DATE OF BIRTH QUALIFICATION OCCUPATION ORGANIZATION AND POSITION
EMERGENCY CONTACT DETAILS NAME
ADDRESS
RELATION TELEPHONE NO.
HEALTH DATA
WEIGHT
HEIGHT (cms) BLOOD GROUP EYESIGHT [SPECIFY POWER IF WEARING GLASSES/LENSES] PHYSICAL DISABILITY (IF ANY)
(kg)
Right Left
IDENTIFICATION MARKS
EDUCATION
1
WHETHER DURATION MONTH & DISTINCTIONS /
SPECIALISA SCHOOL / COLLEGE / UNIVERSIT FULLTIME / GRADE %
EXAMINATION PASSED OF COURSE YEAR OF SCHOLARSHIPS /
TION INSTITUTION Y/ BOARD PARTTIME/ MARKS
CORRES. (Yrs & Mths) PASSING PRIZES WON
SSC OR Equivalent
School leaving Certificate
Intermediate or
12th standard / HSC
DIPLOMA
DEGREE (S)
DIP. CERTIFICATE
POST. GRAD.
DEGREE /
MEMBERSHIP OF PROFESSIONAL INSTITUTE
DURATION OF MEMBERSHIP
NAME OF INSTITUTE TYPE OF MEMBERSHIP AND POSITION HELD
PERIOD FROM TO
TRAINING / CERTIFICATIONS
WHETHER CERTIFICATE
NAME OF THE TRAINING COURSE DURATION YEAR INSTITUTE / ORGANISATION
AWARDED
HAVE YOU EVER BEEN INTERVIEWED BY ANY OF THE L&T GROUP OF COMPANIES?
YES NO DATE/YEAR POSITION COMPANY
If Yes, give
details
RELATIVES / ACQUAINTANCE IN L&T GROUP OF COMPANIES ( EXCEPT L&T TECHNOLOGY SERVICES)
NAME RELATIONSHIP POSITION COMPANY & TELEPHONE NOS.
GENERAL DATA
HOW DID YOU COME TO KNOW OF THIS POSITION?
ARE YOU ENGAGED IN ANY PERSONAL BUSINESS ? if YES,
indicate nature of
YES NO business
DO YOU HAVE ANY CONTRACT / BOND
WITH YOUR PRESENT EMPLOYER? if YES,
Give Details
YES NO
IF SELECTED, WHEN CAN YOU JOIN?
NAME, ADD., AND TEL Nos. OF TWO SUPERIORS FAMILIAR WITH YOUR WORK (NOT RELATIVES)
NAME COMPANY & POSITION TELEPHONE NOS. E-MAIL ID
2
CRIMINA
HAVE YOU EVER BEEN INVOLVED IN ANY CRIMINAL PROCEEDINGS / CONVICTED OF ANY OFFENCE? IF YES, GIVE DETAILS
RECORD
L
DECLARATION UNDER SECTION 188 OF COMPANIES ACT 2013
Note: Hiring of any relatives of Whole Time Directors needs to confirm with the provisions of the Companies Act 2013. Hiring of relatives of Whole
Time Directors and KMPs (covers MD, ED, CFO and Company Secretary) will require the specific permission of the Board of Directors. Hiring of
Relatives of Members of Executive Committee and Leadership Team will require the approval of the CEO & MD.
I hereby declare that I am not connected with any of the Directors of the Company as his partner or his relative as defined under
section 188 of the Companies Act 2013
AND / OR
I hereby declare that I am related to Mr./Ms._________________________________________who is a Director of the Company. My relationship is that of
__________________________________________________________(define relationship as per policy).
DECLARATION UNDER RELATIVE HIRING POLICY
I hereby declare that I am not connected with any of the employee of the Company as his partner or his relative
AND / OR
I hereby declare that I am related to Mr./Ms._________________________________________who is an employee of the Company. My relationship is that of
__________________________________________________________(define relationship as per policy).
AND / OR
I hereby declare that I am not connected with any of the customer/vendor/competitor of the Company as his partner or his relative
AND / OR
I hereby declare that I am related to/partner of/have a business interest with Mr./Ms._______________________________________________who is
customer/vendor/competitor of the Company. My relationship is that of ________________________________________________ (define relationship as per
policy).
I declare that the information given above is true to the best of my knowledge. I am aware that any false or incorrect information by me may result in
termination of my service with the Company. I have no objection to your inquiring from any of my previous employers on any matters pertaining to
me, if I join your Company.
Declaration :Company will not disclose /divulge your personal information (either digital or print form) to third party without your consent except
statutory, legal & business reasons / compulsions.
PLACE DATE Applicant's Signature
