Personal Information Form for Employment
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1 Personal Information Form for Employment A) Read the entire form first and then complete in your own handwriting. Attach separate sheet for any additional information POSITION APPLIED FOR Name (In Full Block Letters) Mr./Mrs./Miss (FIRST) (MIDDLE) (SURNAME) Present Address Tel No. Permanent Address Tel No. Date Of Birth Place of Birth Age (Location) (Country) Sex Marital Status Height Weight Male : Single Married Widowed Female: Divorced Separated No. of children Male Female Family Background Relation Age Father Mother Age(s) Education Level Other Dependents(Specify) Eyesight Normal Occupation/ Designation Citizenship At Birth At Present Corrected : L Blood Group: Physical defects (if any) : R Spouse Brother/ Sister
2 B) Educational Qualifications (State Highest First) School/Co Location Board/ PERIOD llege University or Institution From To Degree/ Diploma/ Certificate obtained Special Subject Class/ Grade/ Marks % C) Languages Known Speak Read Write Fluent Fair Slight Fluent Fair Slight Fluent Fair Slight
3 D) Work experience (list present/last job first- no reference will be made to present employer now) Position Work Description Name and Address of Period Final Salary Reason for Leaving Employer From To E) Describe your training experience (if any) NAME OF COMPANY POSITION NATURE OF TRAINING DURATION FROM TO REMARKS - CATEGORY OF PARTICIPANTS, NO. OF PARTICIPANTS, YOUR ROLE, WERE YOU THE ONLY Sales Trainer / CO-SALES TRAINER, PARTICIPANTS FEEDBACK, SELF ANALYSIS. If you wish to add more details you can attach a separate sheet.
4 F) Explain any breaks in your Educational or Working Career: G) Please mention any other qualifications or certifications which you may have completed successfully H) Describe your self in not more than 100 words. I) What are the near term and medium term personal goals that you wish to achieve? J) Discuss your one most critical achievement and why do you consider it so, your strength to make this achievement. (Approx 10 lines)
5 This section is to be filled by Candidate. K) Salary Details: Current Salary: Gross (in INR) Net (Take Home) (in INR).. Write the break up: Component Amount (INR) Basic Gross ( MWA) Bonus(8.33% of basic; paid monthly) HRA( 30 % of Basic) Conveyance Cell phone Reimbursement (Paid monthly with actual bills) Medical(Paid on submission of monthly bills) Special allowances Gross Salary Leave Encashment allowance Earned Gross PE PF deduction (12% of Basic) PE ESIC deduction(1.75% of Gross) PE Net Take home (Before TDS) Company PF contribution(13.6% of Basic) Company ESIC Contribution(4.75% on gross) Insurance (INR 3,00,000.00) and BGC, access card Mediclaim for self and spouse (INR 1,00,000.00) Company Total Contribution Retention Bonus (Paid annually at completion of 1 year with company) Cost to Company (Monthly) Cost to Company (Annual) L) Salary Expected (INR) : M) Joining time required : N) List references 3 Professional References Name Address, Telephone/ Mobile No. Occupation Years Known In what capacity known 3 Personal References
6 I hereby affirm that all the information furnished in this form is true; any misleading information/details can lead to termination in future during my tenure in company. Place Date O) This section is to be filled by HR of ITCONS e-solutions Pvt Ltd : (Signature) Status of Interview : Reason for Rejection (if Rejected) : Salary Offered with Breakup: Current Salary: Gross (in INR) Write the break up: Net (Take Home) (in INR).. Component Basic Gross ( MWA) Bonus(8.33% of basic; paid monthly) HRA( 30 % of Basic) Conveyance Cell phone Reimbursement (Paid monthly with actual bills) Medical(Paid on submission of monthly bills) Special allowances Gross Salary Leave Encashment allowance Earned Gross PE PF deduction (12% of Basic) PE ESIC deduction(1.75% of Gross) PE Net Take home (Before TDS) Company PF contribution(13.6% of Basic) Company ESIC Contribution(4.75% on gross) Insurance (INR 3,00,000.00) and BGC, access card Mediclaim for self and spouse (INR 1,00,000.00) Company Total Contribution Retention Bonus (Paid annually at completion of 1 year with company) Cost to Company (Monthly) Cost to Company (Annual) Designation offered : Amount (INR) Joining Date :
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