IVRCL Limited

STANDARD APPLICATION FORM

Post Applied for:. Name in full (Block Letter}.. Date of Birth (dd/mm/yyyy) A!e: P"#$#

Blood roup PAN No. ender: %ale / &emale %arital status : %arried / 'nmarried &ather(s / uardian(s Name: Present Address Permanent Address

P"#$#

Name ) Address of contact Person (in case of *mer!ency)

$elephone No. %o+ile: *,mail :

$elephone No. %o+ile:

$elephone No. %o+ile:

Family / Dependent Details

Name -elationship Date of Birth #ccupation

Languages known (Please underline the mother ton!ue)

Lan!ua!es .no/n -ead 0rite

1peak

Educational Qualifications......includin! technical 2ualification 31tart from 114 / 5)

4ourse 'ni7ersity/ institution 8ear of Passin! 4lass ) Percenta!e 1peciali9ation

Please attach the 5ero6 copies in support of the a+o7e 2ualifications Reference ( &urnish particulars of t/o persons not related to you from /hom /e can seek reference) Description Name
#ccupation Address

-eference #ne

-eference $/o

Phone Num+er %o+ile *,mail

Present Employment
Name ) Address of the 4ompany: Date of :oinin!.

. -eportin! $o: At Present:

No. of 1u+ordinates

Desi!nation on ;oinin!: P-#%#$<#N1 Promotion &rom (Des!.) Promotion $o (Des!.) Date

-*%'N*-A$<#N (<n the present *mployment) Particulars =. Basic

>. D. A? <f any

Per %onth

Per Annum

@. "-A A. 4on7eyance ;o+ Description / -esponsi+ilities B. #thers

1u+ $otal C. 1tatutory Benefits a. P.& +. Bonus

ORG !"# $"O! %& R$

Dra/ a +rief schematic dia!ram indicatin! your position in relation to your department and o7erall or!anisation

c.

ratuity

d.
1u+ $otal D. #thers? if any

1u+ $otal 4ost to the company

%inimum salary Accepta+le (Annual cost to the company) ;oinin! $ime -e2uired:

Pre7ious *mployment details (1tart /ith employment prior to current one)

Name ) Address of the *mployer /4ompany Desi!nation / Position held Period of 1er7ice &rom
DD/%%/8888

$o
DD/%%/8888

;o+ -esponsi+ilities

>

FAre you related to any present or e6,employee of the companyG 8es / No <f yes? specify Name: -elationship : Position:

F"a7e you +een employed in our company earlierG 8es / No <f yes? specify? Di7ision/Department: Position : -eason for lea7in!: Period of employment

Declaration : < certify that the statements made +y me are true? complete and correct. < a!ree that incase the company at any time finds that the information !i7en a+o7e is not true? correct or complete? the company /ill ha7e the ri!ht to terminate my employment /ithout any notice or compensation at any time? not /ithstandin! any other terms of employment.

Date :

Place :

1i!nature of the 4andidate