Employment Application Form/BGV Form

Employee ID
Company Name
BGV Check Type    
Address Education Past Employment Reference Check

Personal Details
Please expand initials in your name -- As the same would be used in our Employment records
Title (Mr./Ms.) First Name Middle Name Last Name

Date Of Joining: …………………

 
Gender: Male Female

Nationality: …………………….. Date of Birth : …………………………

Citizenship: ……………………. Place of Birth : ………………………….

Maiden Name (applicable for married ladies): ……………………………………….

Father’s Name : ……………………………………………..

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

Contact Number/s : ………………………………………….

Alternate Number/s : ………………………………………….

Personal Email ID : ………………………………………………………….

Permanent Account Number (PAN) : …………………………..

NASSCOM – NSR (National Skills Registry) – IT PIN Number : ………………………………..

Driving License Number: ……………………………….

Driving License valid up to (mm/dd/yyyy): …………………………………

ADDRESS DETAILS:

Permanent Address:

City: State :

Country: Pin code:

Telephone:

Landmark *:

Is the permanent and present address same?: Yes / No

If No, please mention:

Present Address:

City: State :
Country: Pin code:

Telephone:

Landmark *:

Period of Longest Stay: Present address Permanent address

Address of longest stay in last three years :

Period of stay : From : To:

Education Details (Please mention education details starting from highest full time degree obtained)
Qualificationwith
SpecializationInstitution Name& City Period Program
University Name & City Student ID / Reg No.
(From – To) (dd/mm/yyyy) % age marks / CGPA
(Part Time / Full Time)
(Starting highest)
from (School/College) / Board Affiliated To
PG details:

UG details:

State reasons for gap in education (if any) :

  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 Employee ID, 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.

 Employment details should not include internship experience.

Employment Details (Please mention 2 employments starting from the latest employment during last 5 years)
Note: Verification of your current employment would be obtained on or after joining CareerNet Technologies Private Limited
Sl Company Address Employment Reported to Employme Emp Code / Last drawn Reasons for Mode of separation
No Name (Main office & branch Type (Name & Position nt Period Personnel No. monthly leaving from the organization
where worked) with & & direct contact From - To / Social gross (Pls select the below
Company Telephone Designation/ number) (dd/mm/ Security salary (INR) option)
– Board Line Position held yyyy) No.(Mandatory
if worked in
USA)
Permanent Resignation
Termination
Contract
Absconded
Designation Closed
1

Operations
Employer

………………….. Others(Pls Specify)

Permanent Resignation
Termination
Contract Absconded
Designation Closed
2
Employer

Operations
………………….. Others(Pls Specify)
Break in Employment (If any):

Duration - From Duration - To Reason

Break between Studies and Employment (If any):

Duration - From Duration - To Reason

Total Work Experience : yrs months

Are you currently Employed? : Yes / No

Service Bond Details if any : Yes / No

SECURITY DETAILS:
Is there any case pending against you in any court of law at the time of filling
up this Background Check Form?*

Is there any case pending against you in any university or any other educational
authority/institution at the time of filling up this Background Check Form?*

If the answer to any of the above mentioned question is YES give full particulars
of the case / arrest /detention / fine /conviction / sentence / punishment etc. and
/ or the nature of the case pending in the Court / University / Educational
authority etc. at the time of filling this form.(Attach additional sheet, if required).*

Reference Details

(Please provide only one reference from each of your past employment. Please do not provide
references if you do not have past employment experience.)

Reference 1:

Name:

Designation:

Organization Name:

Address:

Contact No:

Nature of Acquaintance: (example: Colleague / Team mate)

Period of Acquaintance: (example: Sept ‘2007 to July’2010)

Reference 2:
Name:

Designation:

Organization Name:

Address:

Contact No:

Nature of Acquaintance: (example: Colleague / Team mate):

Period of Acquaintance: (example: Sept ‘2007 to July’2010):

Declaration:
Have you submitted all the documents – Yes / No

If No, please mention the documents along with the reason for non-submission of the same.

Sl.No. Documents Reason for non submission

 (For HR Use Only)

Checklist for BGV Documentation

Sl No Particulars Availability Remarks
1 Past
Employment - 1
Relieving Letters
Appointment
Letters Offer
Letters
Experience
Certificates
Signatures
Other Employment
Documents Past
Employment - 2 Relieving
Letters Appointment
Letters

Offer Letters
Experience
Certificates
Signatures
Other Employment Documents

2 Education
Educational
Certificate Mark
sheets Self-
Attestation
Check for Non-Completion
Other Educational Documents

3 Reference Details
Reference - 1
Referee Name
Referee Phone
Number Referee
e-mail ID Referee

relation
Reference - 2
Referee Name
Referee Phone
Number Referee
e-mail ID Referee
relation
4 Address Details
Permanent
address details
Permanent
address proof

5 Other Documents