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Application for Employment

Our policy is to provide equal employment opportunity to all qualified persons without regard to race, creed, color, religious belief, sex, age, national origin, ancestry, physical or mental disability, or veteran status.

Date ______________

Last name ________________________  First name ________________ Middle name________

Street Address _________________________________________________________________

City _____________________  State _______  PIN _______

Telephone ___________________________PAN Number___________________________

Position applied for __________________________________________

How did you hear of this opening? __________________________________________

When can you start? _____________________  Desired Salary ______________

Are you an Indian citizen or otherwise authorized to work in India on an unrestricted basis? (You may be required to provide documentation.)  Yes   No

Are you looking for full-time employment?  Yes    No

If no, what hours are you available? ______________

Have you ever been convicted? (This will not necessarily affect your application.)    Yes    No

If yes, please describe conditions. __________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

Education        

School Name and Location                                     Year      Major   Degree

High School ________________________________________        ______ ______ ______

College ___________________________________________        ______ ______ ______

College II(If applicable)_______________________________        ______ ______ ______

Post-College _______________________________________        ______ ______ ______

Other Training ______________________________________         ______ ______ ______

In addition to your work history, are there other skills, qualifications, or experience that we should consider? ______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

Employment History         (Start with most recent employer)

Company Name ________________________________________________________________

Address ____________________________________ Telephone _________________________

Date Started ___________  Date Ended ___________  

Current CTC____________  

Name of Supervisor ____________________Email:  ________________ Telephone:___________

May we contact?  Yes    No

Responsibilities _______________________________________________________________

_____________________________________________________________________________

Reason for leaving ______________________________________________________________

Company Name II_______________________________________________________________

Address ____________________________________ Telephone _________________________

Date Started ___________  Date Ended ___________  

Current CTC____________  

Name of Supervisor ____________________Email:  ________________ Telephone:___________

May we contact?  Yes    No

Responsibilities _______________________________________________________________

_____________________________________________________________________________

Reason for leaving ______________________________________________________________

Company Name III_____________________________________________________________

Address ____________________________________ Telephone _________________________

Date Started ___________  Date Ended ___________  

Current CTC____________  

Name of Supervisor ____________________Email:  ________________ Telephone:___________

May we contact?  Yes    No

Responsibilities _______________________________________________________________

_____________________________________________________________________________

Reason for leaving ______________________________________________________________

Attach additional information if necessary.

I certify that the facts set forth in this application for employment are true and complete to the best of my knowledge. I understand that if I am employed, false statements on this application shall be considered sufficient cause for dismissal. This company is hereby authorized to make any investigations of my prior educational and employment history.

I understand that employment at this company is “at will,” which means that either I or this company can terminate the employment relationship at any time, with or without prior notice, and for any reason not prohibited by statute. All employment is continued on that basis. I understand that no supervisor, manager, or executive of this company, other than the president, has any authority to alter the foregoing.

Signature_______________________________________________   Date _________________