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Pratiti Data - Form

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SHAILESH JORE
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37 views

Pratiti Data - Form

Uploaded by

SHAILESH JORE
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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Pratiti Technologies Pvt. Ltd.

Confidential

DATA FORM

PERSONAL INFORMATION

First Name

Middle Name

Last Name Paste recent photo


here
Mobile No.

Email

Date of Birth Place of Birth


(dd/mm/yyyy)
Marital Status Nationality

Present Address

City State PIN Code


Telephone Residence
Permanent
Address
City State PIN Code
Telephone Residence
PAN Card Do you have a PAN Card? Yes / No / Applied
If yes, please provide PAN No.
If applied, please provide Acknowledgment No.
Blood group
Passport Do you have a valid passport? Yes / No / Applied
If yes, valid until (mm/yyyy)
Visas Please provide info regarding valid visas (Country or region, Type of visa, Valid up to)

Family members Occupation Designation Name of the organization


Father
Mother
Spouse
Siblings

1
Pratiti Technologies Pvt. Ltd.
Confidential

EDUCATION

IIT/JEE Rank Year of Exam


AIEEE (All India Rank) Year of Exam
GATE Score (Percentile) Year of Exam

%
Degree Name of
Discipline / From To Name of marks /
Level / Exam Board /
Specialization (YYYY) (YYYY) Institution GPA (*)
Name University

XII

Graduation

Post-
graduation

Other 1

Other 2

(*) For graduation and post-graduation, please mention aggregate of all semesters

Achievements in Education

Reason for gaps, if any, in


education

Professional training courses:


Approximate Course
Course duration completed
Name of Training Institution
(months) in year
(yyyy)

2
Pratiti Technologies Pvt. Ltd.
Confidential

WORK EXPERIENCE

Follow reverse chronological order

Organization Location/s From To Designation Reason for Annual gross


(mm/yyyy) (mm/yyyy) while leaving leaving salary
Joining Leaving

Achievements in Work

Membership of professional bodies


(e.g. CSI, IEEE)
Reason for gap, if any, in work

3
Pratiti Technologies Pvt. Ltd.
Confidential

OTHER INFORMATION

References: Please provide the details of 2 persons (not relatives)


Name Address Telephone Email Occupation

Notice period for joining (In days)


Last working day with current employer (if already resigned)
Do you have any kind of service bond with current employer?
If yes, what is the expiry date of the bond?

Break-up of the present salary, benefits, and perquisites:


Monthly income Annual benefits
Basic LTA
DA Bonus
HRA Medical
Conveyance PF
Special allowance Housing
Others Gratuity
Others
Total Total
Total Annual Gross:

Expected annual gross salary ______________________________

Declaration by the applicant:

I confirm that the information provided by me in this application form is accurate and correct. And I
understand that in the event of any information found to be wrong, it could result in termination of my
employment without any notice.

Date:

Signature:

4
Pratiti Technologies Pvt. Ltd.
Confidential

We thank you and appreciate all your efforts put in to complete this application.
All the information in this form will be kept strictly confidential.

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