Jayalakshmi Fertilisers

Employee Application Form

APPLICATION FOR THE POST OF

1. Name (in Full)

Upload Photo

2. Father’s/Husband’s Name

3. Date of Birth

Age

4. Mobile No.

5. E-Mail

6. Present Address for Communication (with Pin Code)

Same as Present Address

7. Permanent Address(with Pin Code)

8. Marital Status

No. of Children

9. Nationality

Religion

10. Educational Qualification: (Given Details from High School)

Educational Qualification	Year of passing	Subjects	Board/ University	Regular/ Distance Education	Percentage of Marks

Certificate attachments

11. Languages Known

12. Computer Knowledge

13. Experience Data

Name of the Organization	Designation Held	Details of the Job	Joining Date	Date of Leaving	Last Salary Drawn+ perks	Leaving Reason

Previous Company Offer Letter Attachments

14. Reason for leaving the current organization:

15. Have you appeared the Interview before with Jayalakshmi Fertilisers?

Yes No

16. Have you over suffered from any long: Chronic disease ? If so, please give details

Yes No

17. Had you ever been convicted in the : Court of law ? If yes, please give details

Yes No

Family Details

Name	Relationship	Age(Years)	Occupation	Monthly Income

19. Do you have any relative working in our company?

Yes No

i) Name

ii) Nature of Association

iii) Period of Association

20. Present CTC per Annum

Expected CTC per Annum

21. Please mention how much time: You require joining us

22. Please give two industry Officials references / Present Reporting persons reference:

SNo	Name	Phone	Company	Designation
1
2

DECLARATION

I hereby certify that the foregoing information is correct to the best of my knowledge and belief and nothing has concealed. If at any time, I am found to have given any false details or information; my appointment shall be liable to summary dismissal without any notice or compensation.

Date:

Place:

(Name of the Applicant)