Trainees Application Form
Trainees Application Form
Preferred Location:
(Note: Mentioned number (1 -14) in terms of your preference. 1 being your 1st preference)
___________________________________________________
Native Place: ______________________
E-mail ID: _______________________
Mobile No.: ____________________ Emergency Contact No: _________________
Date of Birth: ________________ Age: ________ Sex: Male/Female: _________
1.
2.
3.
4.
SEMESTERWISE MARKS
Name : _____________________________________________
Discipline : _____________________________________________
Name of Institute : _____________________________________________
TOTAL
Any Gap during Education. If Yes, please mention the year and the reason for the gap:
___________________________________________________________________________
__________________________________________________________________________
_______________________________________________________________________
MEDICAL HISTORY:
Have you suffered any major ailment/accident? Or Have you undergone any major
surgery or are you undergoing any treatment ( Yes / No)
If yes, please give details_________________________________________________
___________________________________________________________________
___________________________________________________________________
2
Are there any hereditary disease in the family (Yes / No). If yes, give details.
__________________________________________________________________
___________________________________________________________________
Do you have any physical limitation or have any irreversible medical conditions
(Yes / No)
___________________________________________________________________
___________________________________________________________________
OTHER DETAILS:
Have you ever been involved in any misconduct or disciplinary case or criminal case?
(Yes / No)
___________________________________________________________________
___________________________________________________________________
Do you have any relatives who are working or have worked in the past with Torrent
Group?
If yes, please specify the details: __________________________________________
DECLARATION:
I hereby declare that all the details furnished above are true to the best of my knowledge and
belief. I further declare that my appointment may be cancelled, at any stage, if I am found
ineligible and/or the information provided by me is found to be incorrect.
Date :
Place : (Signature of Applicant)