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FOR OFFICE USE ONLY

REQUIREMENT REF SALARY EXPECTED CALLED ON

CLIENT / AREA / PROJECT SALARY OFFERED INTV. ON

POSITION SELECTED ENTRY DATE

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REMARKS
YES NO

PERSONAL APPLICATION
PLEASE FILL IN THE COMPLETE DETAILS IN PRINT AND ATTACH PHOTOCOPIES OF
CREDENTIALS AND REFERENCES

BAR CODE POSITION APPLIED

SECOND CHOICE

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NAME AS PER PASSPORT

DATE OF BIRTH AGE PLACE OF BIRTH RELIGION CASTE

FATHERS NAME MOTHERS NAME

SPOUSE NAME NO. OF CHILDREN

PASSPORT DETAILS
ISSUE EXPIRY ISSUED
PASSPORT NUMBER ECNR ECR
DATE DATE AT

EDUCATIONAL / TECHNICAL QUALIFICATIONS & CERTIFICATIONS


UNIVERSITY / INSTITUTE DEGREE / DIPLOMA / OTHERS* YEAR GRADE DETAILS

COMPUTER KNOWLEDGE

SOFTWARES USED

EMPLOYMENT RECORDS
EMPLOYERS TITLE FROM TO SALARY

GIVE DESCRIPTION OF DUTIES, RESPONSIBILITIES AND EQUIPMENTS USED -

NOTICE PERIOD REQUIRED TO JOIN ? SALARY EXPECTED

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LICENCE # B-0438/MUM/PER/1000+/5/5268/1999
Plot # 8, Shah Industrial Estate, Off Veera Desai Road. Andheri (W), Mumbai - 400 053.
Tel : + 91 22 26748100 / 113 fax + 91 22 26731878 email : indman@indman.com
ADDITIONAL EXPERIENCE DETAILS

EMPLOYERS TITLE FROM TO SALARY

GIVE DESCRIPTION OF DUTIES, RESPONSIBILITIES AND EQUIPMENTS USED

INDICATE GOOD OR FAIR DRIVERS & OPERATORS


KNOWLEDGE OF LANGUAGES
READ WRITE SPEAK TYPE OF LICENCE/S COUNTRY OF LISC. ISSUE DT. EXP. DT. ORIGINAL / COPY

L.M.V.

H.M.V.

EQUIPMENT OPERATORS PLEASE SPECIFY EQUIPMENT USED / OPERATED

MAKE OF EQUIPMENT USED MODEL NO. EQUIP. CAPACITY CAPACITY LIFTED DETAILS

PLEASE READ CAREFULLY


APPLICANT'S CERTIFICATION AND AGREEMENT

MAY WE CONTACT YOUR PRESENT EMPLOYER NOW WITHOUT JEOPARDIZING YOUR POSITION ?

HAVE YOU EVER BEEN ARRESTED OR CONVICTED OF A FELONY? IF YES, PLEASE GIVE FULL DETAILS-

I) I HEREBY CERTIFY THAT THE ANSWERS GIVEN AND STATEMENTS MADE ARE TRUE AND CORRECT. IHEREBY AUTHORIZE ALL MY PREVIOUS EMPLOYERS AND
REFERENCE TO FURNISH ANY INFORMATION CONCERNING MY PERSONAL CHARACTER, HABITS AND EMPLOYMENT RECORDS.

2) I AM SUBMITTING HEREWITH MY ORIGINAL PASSPORT WITH INDMAN CONSULTANTS BY AUTHORIZING THEM TO PROCESS MY OVERSEAS EMPLOYMENT VISA AND
OTHER RELATED TRAVEL DOCUMNTS AS PER AGREED TERMS. I AGREE TO REIMBURSE THE EXPENSES INCURRED BY INDMAN CONSULTANTS TOWARDS
PROCESSING OF MY TRAVEL DOCUMENTS IF I WITHDRAW MY DOCUMENTS AFTER PROCESSING MY VISA.

3) I UNDERSTAND THAT ANY MISREPRESENTATION OR MATERIAL OMISSION MADE ON THIS FORM OR ANY OTHER RELEVANT DOCUMENTS, TENDERS ME LIABLE TO
DISMISSAL WITHOUT NOTICE AND I HEREBY WAIVE ALL MY RIGHT RECOURSE.

4) I UNDERSTAND THAT INFORMATION AND ANY DOCUMENTS PROVIDED IS WITHOUT OBLIGATION TO INDMAN CONSULTANTS OR TO THEIR PRINCIPAL ARE NOT
RETURNABLE.

NAME AND CONTACT NO. IN CASE OF EMERGENCY TEL. NO.

PRESENT ADDRESS PERMANENT ADDRESS

MOBILE No. EMAIL TEL. NO.

APPLICANTS SIGNATURE DATE

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