EMPLOYMENT APPLICATION FORM

To be filled completely and clearly by the candidate

*Indicates Mandatory fields

Personal Details (in BLOCK LETTERS)

Prefix Mr. Mrs. Ms. Dr.

First Name*
(As per Aadhaar
Card)
Middle Name
(As per Aadhaar *Affix Passport
Card) Size Photograph
Last Name*
(As per Aadhaar
Card)
Date of Birth*
(dd/mm/yyyy)

Age Gender

State of Birth Nationality

Country of Birth Birth Location (City/Town)

Blood Group

Marital Status *

PAN Number *

Personal Email
ID*

Mobile Number *
Bachelors Level Degree Masters Level Degree Doctorate (Academic)
Highest Doctorate (Professional) Graduate Certificate
Education Level* Graduate Diploma Trade Course/Diploma

Emergency Contact Details

Emergency contacts *
Name and Address

Telephone Number(s)/Cell

Relationship with the

candidate *

1|Page S i g n a t u r e o f t h e c a n d i d a t e: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
 EMPLOYMENT APPLICATION FORM
Address
Details
Present (Mailing Address) Permanent Address

Address*

Nearest Land Mark

Any*
City/Town
County/District

State

Pin Code*
Phone Number
(with STD Code)

Family Details

Sr. Name Date of Birth Relation to Occupation

No. (dd/mm/yyyy) Person

1 Father

2 Mother

3 Spouse

4 Daughter/Son

5 Daughter/Son

6 Daughter/Son

Other Dependant/
7 IF ANY

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 EMPLOYMENT APPLICATION FORM
*Education Details:

Education Details*
(Graduation, Post-Graduation and any other qualification)

Sr. University Name and Institution / College Type of Degree/ Registration Date CGPA/Grade
No. Address *(Provide full name & Address) degree Diploma Number / Graduated / Percentage
*(Provide full name & Address) (HSC, Diploma /
(ex- BA, BSc, Enrolment (mm/yyyy) (Aggregate for
Degree, PG)
MA, MSc, etc.) number all semesters /
& Specialization all years)

01 10th

02 12th

Graduation
03
Diploma

Post-
04
Graduation

Professional
Qualification/
05
Certificate
courses

3|Page Signatureofthecandidate:_______________
 EMPLOYMENT APPLICATION FORM
*Work Experience

Total Experience: Years Months

*Work Experience Details(In reverse chronological order, starting with present employment)

S. *Name of Company Start Date End Date Employee Last Last drawn VARIABLES *NAME & DESIGNATION OF
No Company’s Address and dd/mm/yyyy dd/mm/yyyy ID Designation total fixed / BONUS IMMEDIATE SUPERIOR
Phone Number Number CTC per PER ANNUM WITH CONTACT DETAILS
annum

01
Industry Type: PH:

02
Industry Type: PH:

03
Industry Type: PH:

04
Industry Type: PH:

05
Industry Type: PH:

4|Page Signatureofthecandidate:_______________
 EMPLOYMENT APPLICATION FORM

Membership of professional institute:

Name of Institute Type of From To (dd/mm/yyyy)

Membership and (dd/mm/yyyy)
position held

Draw in brief the organization structure of the company where you are presently
employed indicating two levels above and one level below your position (please also
indicate the total number of persons under you.)

Have you ever been interviewed by SBI Life or any of the SBI Group of Companies?

YES/NO

If YES, Date/Year: Position: Company:

Have you ever worked with SBI Life before?

YES/NO

If YES, E mp l o y e e I D : From: ____ To: ___Designation:

Reason for leaving:

Relatives/Acquaintance in SBI/SBI Life:

Name Relationship Position Company &

Telephone

Who referred you to us?

5|Page Signatureofthecandidate:_______________
 EMPLOYMENT APPLICATION FORM
Are you engaged in any personal business? YES/NO

If YES, indicate nature of business:

Are you an Insurance Advisor of SBI Life? YES/NO If YES, IA Code

Are you an Insurance Advisor of any other Company? YES / NO

If YES, Name of the Company: IA Code

Do you have any contract/bond with your present employer? YES/NO

If YES, give details:

Name, Add., and Tel Nos. of two references familiar with your work (not relatives)
who can be contacted for reference check

Name Address Telephone Nos. Company & Position

Have you ever been involved in any criminal proceedings/convicted of any offence? If
YES, give details:
_

Declaration

I confirm that none of my relatives (spouse, dependant children, or dependant step children,
whether residing with the employee or not" ) are working as insurance Advisor with SBI Life
Insurance Co. Ltd. I undertake that in future, if any of my relatives is appointed as an Insurance
Advisor/Agent of SBI Life Insurance, I will inform the Company.

I confirm that the above information is correct to the best of my knowledge and I understand
that misrepresentation of information on this application form may, in event of my obtaining
employment, result in action based on Company policy.

I hereby authorize SBI Life Insurance Company Limited (or a third-party agent appointed by the
Company) to contact any former employers as indicated above and carry out all background
checks, not restricted to education and employment, as deemed appropriate through this
selection procedure.

I authorize former employers, agencies, educational institutes etc. to release any information
pertaining to my employment/education and I release them from any liability in doing so.

I also authorize SBI Life Insurance Co. Ltd. to share/provide information covering my services
with the Company to any third party/agency/repository to facilitate a reference check. This
authorization survives any cessation of service/training with the Company.

Place: Date:

6|Page Signatureofthecandidate:_______________