Accenture Services Private Ltd Doc Ver 2.

Employment Application Form

For internal use only: To be filled by Accenture

Employee ID Number: Please attach recent
Date of Joining :
passport size
Workforce :
photograph
 Please provide complete and correct information.
 All fields are mandatory.
 Please do not use short forms / abbreviations.
 Hardcopy of this form along with supporting documents has to be submitted
(duly signed & with a recent colour photograph) to your location contact point.
 Personal Details
Please expand initials in your name -- As the same would be used in our Employment records

Title (Mr./Ms.) First Name Accenture Last

Middle Name Services
Name Private Ltd Doc Ver 2.5

Primary Skill /
Competency Education
Gender: o Male o Female Education
Nationality: ………………….. Citizenship: Details
…………………

Date of Birth : …………………………

Qualification with Institution Place
Name &ofCity
Birth:…………………………….
University Name & City Period Student ID /
Program
Specialization (School/College) / Board Affiliated To (From – To) Reg No. % age marks /
Maiden (Starting
Name: (applicable (Part Time / Full
from most for married ladies): ………………………………………. (dd/mm/yyyy) CGPA
Time)
recent)
Father’s Name: …………………………………..

Mother’s Name: …………………………………...............

Mother’s Maiden Name: …………………………………..

Contact Number/s: …………………………………………

HSC/ID12th
Personal Email : ………………………………………………………….

Alternate Email ID: …………………………………………………………..

SSC/ 10th
Current Address : Permanent Address :

Others

State reasons for gap in education (if any) :

Phone Number : Phone Number :

Current Address Permanent Address

From To From To
Period Of Stay (month/year) (month/year) (month/year) (month/year)

If you do not have a Passport, it is recommended that you apply for the same before joining.

Passport Number :
 Accenture Services Private Ltd Doc Ver 2.5

Employment section: Please give details of previous employers.

Ensure that you are descriptive wherever necessary – e.g. If your previous company is closed
down, please do mention it. Telephone Number with specific location code, Employee Code/ ID/
Number is mandatory. If your previous employer did not provide the latter, please mention and
state reasons for the same.

* Employment details should be of the company you are on payrolls of, not of a company you are
deputed to on an assignment with

• In case you are showing employments experience in a skill enabling or professional

Training institute the same should only be shown if you were on the payrolls of such an
institute.
 Accenture Services Private Ltd Doc Ver 2.5

Employment History (Please mention starting from the latest employment)

Details of Employer 1

Company Name: Position Held:

Address (main office and branch where worked) Company Telephone

Board Line:

Employment Period: (dd/mm/yyyy) Reported to

From To Name, Designation,

contact no -
company Landline
(direct extension
number)

Whether employment is of permanent or temporary nature (Contract positions are temporary).

o Permanent o Temporary Employee Code / Personnel Number:

Social Security Number (mandatory if worked in U.S.A):

Responsibilities:

Last drawn monthly gross salary (INR) Reason(s) for leaving

Mode of separation from the organization – Choose one from the following options.

o Resignation
o Termination
o Retirement
o Absconded
o Closed the operations
o Others (pls specify)

Note: Verification of your current employment would be obtained on or after joining Accenture.
 Accenture Services Private Ltd Doc Ver 2.5

Employment History

Details of Employer 2

Company Name: Position Held:

Address (main office and branch where worked) Company Telephone

Board Line:

Employment Period: (dd/mm/yyyy) Reported to

From To Name, Designation,

contact no -
company Landline
(direct extension
number)

Whether employment is of permanent or temporary nature (Contract positions are temporary).

o Permanent o Temporary Employee Code / Personnel No:

Social Security Number (mandatory if worked in U.S.A):

Responsibilities:

Last drawn monthly gross salary (INR) Reason(s) for leaving

Mode of separation from the organization – select from the below options.

o Resignation
o Termination
o Retirement
o Absconded
o Closed the operations
o Others (pls specify)

Note: Verification would be conducted post offer acceptance

 Accenture Services Private Ltd Doc Ver 2.5

Employment History

Details of Employer 3

Company Name: Position Held:

Address (main office and branch where worked) Company Telephone

Board Line:

Employment Period: (dd/mm/yyyy) Reported to

From To Name, Designation,

contact no -
company Landline
(direct extension
number)

Whether employment is of permanent or temporary nature (Contract positions are temporary).

o Permanent o Temporary Employee Code / Personnel No:

Social Security Number (mandatory if worked in U.S.A):

Responsibilities:

Last drawn monthly gross salary (INR) Reason(s) for leaving

Mode of separation from the organization – select from the below options.

o Resignation
o Termination
o Retirement
o Absconded
o Closed the operations
o Others (pls specify)

Note: Verification would be conducted post offer acceptance

Accenture Services Private Ltd Doc Ver 2.5
 Accenture Services Private Ltd Doc Ver 2.5

Employment History

Details of Employer 4

Company Name: Position Held:

Address (main office and branch where worked) Company Telephone

Board Line:

Employment Period: (dd/mm/yyyy) Reported to

From To Name, Designation,

contact no -
company Landline
(direct extension
number)

Whether employment is of permanent or temporary nature (Contract positions are temporary).

o Permanent o Temporary Employee Code / Personnel No:

Social Security Number (mandatory if worked in U.S.A):

Responsibilities:

Last drawn monthly gross salary (INR) Reason(s) for leaving

Mode of separation from the organization – select from the below options.

o Resignation
o Termination
o Retirement
o Closed the operations
o Others (pls specify)

Note: Verification would be conducted post offer acceptance

 Accenture Services Private Ltd Doc Ver 2.5

Employment History

Details of Employer 5

Company Name: Position Held:

Address (main office and branch where worked) Company Telephone

Board Line:

Employment Period: (dd/mm/yyyy) Reported to

From To Name, Designation,

contact no -
company Landline
(direct extension
number)

Whether employment is of permanent or temporary nature (Contract positions are temporary).

o Permanent o Temporary Employee Code / Personnel No:

Social Security Number (mandatory if worked in U.S.A):

Responsibilities:

Last drawn monthly gross salary (INR) Reason(s) for leaving

Mode of separation from the organization – select from the below options.

o Resignation
o Termination
o Retirement
o Closed the operations
o Others (pls specify)

Note: Verification would be conducted post offer acceptance

 Accenture Services Private Ltd Doc Ver 2.5

Letter of Authorization
To whom it may concern

I understand that employment with Accenture is governed by Accenture Employment

Policies as applicable, including satisfactory information from a background check

I hereby authorize Accenture Services Private Ltd and its representative to verify
information provided in my resume and application of employment, and to conduct
enquiries as may be necessary, at the company's discretion. I authorize all persons who
may have information relevant to this enquiry to disclose it to Accenture Services Private
Ltd. or its representative. I release all persons from liability on account of such
disclosure.

I hereby certify all of the statements made on the Accenture Services Private Ltd
employment verification form are true and complete and I understand that omission or
misrepresentation of any fact may result in refusal of employment or immediate
dismissal.

Signature :

Name in Capitals :

Date :

For internal use only: To be filled by Accenture

*Signature of the Recruiter :

Name of the Recruiter :

Date :

* The Signature of the recruiter needs to be present in case the application is sent as soft copy
and does not have the signature of the candidate.

The hardcopy of the email received also needs to be submitted along with this form as an
audit trail.
 Accenture Services Private Ltd Doc Ver 2.5

Documents required:

We request you to arrange for the following mandatory documents and keep them ready as they
would be required to be submitted at different stages of recruitment.

Photocopies of:

• Salary Slip for any one month in last three months, for immediate previous employment
• Degree certificate for highest qualification
• Final year or term or semester mark sheet

• Full and final settlement certificate or service certificate or relieving letter for all previous
employments in the last three years.

• Passport or Voters ID Card or Driving License or Ration Card

• PAN Card (if not available, kindly apply for the same and provide proof of application/
acknowledgement copy from IT dept.)

• Relieving Letter/ Service Certificate of your last organization.

• 5 Recent passport size photographs