EmployABILITY 2019
TUESDAY 17 DECEMBER 2019, CHENNAI

ELIGIBILITY CRITERIA:
· Candidate should be a person with disability as per the Persons with Disabilities Act.
· Candidate must be at least a graduate from recognised educational institution with knowledge of English and basic computer skills.

INSTRUCTIONS TO CANDIDATES:
1. Please fill this application in ENGLISH ONLY
2. Questions marked with * are compulsory.
3. Please ensure that the application form is complete.
4. Completed applications must reach on or before Saturday 30 November 2019.
1. PERSONAL DETAILS
Name *
Your answer
Date of birth (dd/mm/yyyy) *
Your answer
Gender *
Qualification *
Your answer
Father /Mother's Name *
Your answer
Address for communication *
Your answer
City / District *
Your answer
Pincode *
Your answer
State *
Permanent address - same as above *
If no, your address
Your answer
City / District
Your answer
Pincode
Your answer
State
Telephone number (with STD code)
Your answer
Candidate's mobile number *
Your answer
Alternate number (family / friend's number ) *
Your answer
E-mail id of the candidate *
Your answer
Alternate e-mail id *
Your answer
2. EDUCATIONAL QUALIFICATIONS
Class X
Name of School and Location *
Your answer
Board (Eg: Matric / CBSE / ICSE) *
Your answer
Month & year of completion (mm/yyyy) *
Your answer
Percentage of marks (%) *
Your answer
Medium of Instruction *
Your answer
Class XII
Name of School and Location
Your answer
Board (Eg: State / CBSE / ICSE)
Your answer
Month & year of completion (mm/yyyy)
Your answer
Percentage of marks (%)
Your answer
Medium of Instruction
Your answer
Diploma
Have you completed Diploma (Eg: DME/ DCSE)? *
If yes, mention the degree (Eg : DME / DCSE)
Your answer
If yes, mention the specialisation (Eg: Electrical/ Computer Science/ Hotel Management/Multimedia)
Your answer
Name of college and location
Your answer
Name of university
Your answer
Month & year of joining (mm/yyyy)
Your answer
Month & year of completion (mm/yyyy)
Your answer
Percentage of marks (%)
Your answer
Medium of instruction
Your answer
Undergraduate Degree (UG)
Have you completed an undergraduate degree (Eg : BA / BSC/ BCOM/BE) *
If yes, mention the degree
Mention the specialisation (Eg: History/ Chemistry/ Mechanical / Electrical & Electronic)
Your answer
Name of college and location
Your answer
Name of university
Your answer
Month & Year of joining (mm/yyyy)
Your answer
Month & year of completion (mm/yyyy)
Your answer
Duration of the course (in years)
Your answer
Percentage of marks (%)
Your answer
Medium of instruction
Your answer
Postgraduate Diploma
Have you completed a postgraduate diploma (Eg: PGDCA/ PGDHRM etc) *
If yes, mention the degree (Eg: PGDCA/ PGDHRM etc)
Your answer
If yes, mention the specialisation (Eg: Computer/ HR / Multimedia/ Labour Law)
Your answer
Name of college and location :
Your answer
Name of university
Your answer
Month & year of joining (mm/yyyy)
Your answer
Month & year of completion (mm/yyyy)
Your answer
Duration of the course (in years)
Your answer
Percentage of marks (%)
Your answer
Medium of instruction
Your answer
Postgraduate Degree
Have you completed a postgraduate degree *
If yes, mention the degree
Mention the specialisation (Eg: Psychology/ Finance/ computer/ History/ English)
Your answer
Name of college and location
Your answer
Name of university
Your answer
Month & year of joining (mm/yyyy)
Your answer
Month & year of completion (mm/yyyy)
Your answer
Duration of the course (in years)
Your answer
Percentage of marks (%)
Your answer
Medium of instruction
Your answer
Other Degrees
Have you completed any other degree (Eg: CA/ MBBS / BDS / M.Phil/ Doctorate) *
If yes, mention the degree
Your answer
Mention the specialisation (Eg: Economics/ History/ Homeopathy)
Your answer
Name of college and location
Your answer
Name of university
Your answer
Month & year of joining (mm/yyyy)
Your answer
Month & year of completion (mm/yyyy)
Your answer
Duration of the course (in years)
Your answer
Percentage of marks (%)
Your answer
Medium of instruction
Your answer
Brief details of Academic Projects (if applicable):
In case of computer based projects, please indicate in ‘Description’ the front end and back end applications used
Project 1
Academic year (1st year, 2nd year ....)
Your answer
Title of the project
Your answer
Name of the organisation
Your answer
Duration of the project (in weeks)
Your answer
Description
Your answer
Project 2
Academic year (1st year, 2nd year ....)
Your answer
Title of the project
Your answer
Name of the organisation
Your answer
Duration of the project (in weeks)
Your answer
Description
Your answer
Project 3
Academic year (1st year, 2nd year ....)
Your answer
Title of the project
Your answer
Name of the organisation
Your answer
Duration of the project (in weeks)
Your answer
Description :
Your answer
Other projects if any
Your answer
3. Computer Skills
MS Word *
MS Excel *
MS Power Point *
MS Access *
Others
Your answer
4. Advanced Computer Skills
a) Programming Languages : *
If yes, give details (Eg: C, C++, etc.)
Your answer
b) Operating Systems *
If yes, give details (Eg: Windows, Linux, etc.)
Your answer
c) Software Packages *
If yes, give details (Eg.Tally, SAP, RDBMS, etc.)
Your answer
d) Web Programming Languages *
If yes, give details (Eg: HTML, Adobe softwares, Java Script, CSS, etc.)
Your answer
e) Hardware & Networking *
If yes, give details (Eg: Troubleshooting, LAN / WAN, etc.)
Your answer
Others
Your answer
5. Additional Qualifications
a. Languages known (click below box )
English *
Required
Tamil
Hindi
Other Languages
Your answer
b. Typewriting
English typing speed
Tamil typing speed
Hindi typing speed
Others (specify language and typing speed)
Your answer
c. Any other qualification
Give details of any other qualification
Your answer
6. WORK EXPERIENCE
Do you have any work experience *
Current employment details
Company name
Your answer
Designation
Your answer
Nature of work
Your answer
Date of joining (dd/mm/yyyy)
Your answer
Last salary drawn (per month)
Your answer
Previous employment history
1.Company name
Your answer
Designation
Your answer
Nature of work
Your answer
Date of joining (dd/mm/yyyy)
Your answer
Date of leaving (dd/mm/yyyy)
Your answer
Total duration in months
Your answer
Last salary drawn (per month)
Your answer
2.Company name
Your answer
Designation
Your answer
Nature of work
Your answer
Date of joining (dd/mm/yyyy)
Your answer
Date of leaving(dd/mm/yyyy)
Your answer
Total duration in months
Your answer
Last salary drawn (Per Month)
Your answer
3.Company name
Your answer
Designation
Your answer
Nature of work
Your answer
Date of joining (dd/mm/yyyy)
Your answer
Date of leaving (dd/mm/yyyy)
Your answer
Last salary drawn (Per Month)
Your answer
7. DETAILS OF DISABILITY:
Type of Disability *
i) If blind or low vision
Describe the degree of vision (power) you have in one or both eyes.
Left eye
Your answer
Right eye
Your answer
Do you know braille?
Do you use computers?
Do you use any assistive device / technology to use computers? (Eg: Magnifier/ JAWS ).
If yes, please specify.
Your answer
Do you use any assistive device for reading? (Eg: Magnifier )
If yes, please specify
Your answer
ii) If hearing impairment or speech & language disability
Level of hearing loss
Do you
Do you use hearing aid?
iii) If locomotor disability :
Give details of disability
Do you use any assistive device for mobility? (Eg: calipers, crutches, wheelchair etc)
If yes, please specify.
Your answer
For all other disabilities
Specify the disability
Accommodations received from your educational institutes (Eg: extra time during exams / scribe) *
Give details of your disability in not more than 50 words *
Your answer
Additional information
Are you willing to work in night shifts? *
Are you willing to relocate as per the job requirement ? *
Do you need any extra assistance / assistive device / assistive technology in the work place? *
If yes, please specify
Your answer
DECLARATION
I declare that all the information given in this form is true
Place *
Your answer
Date (dd/mm/yyyy) *
Your answer
Note
1. Candidate whose application form has been accepted will receive venue entry form by email within 5 working days.
2. Only registered candidate with venue entry form will be permitted to enter the job fair.
3. For more details please contact: employability@abilityfoundation.org or call 044 24520016 / +91 8939675544
Disclaimer
· The organisers do not guarantee job placements
· The organisers do not charge/accept money for assisting candidates.
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