Jayalakshmi Fertilisers

Personal Information

1. Name (in Full) *

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2. Father's/Husband's Name *

3. Date of Birth *

Age

4. Mobile No. *

5. E-Mail *

Address Details

6. Present Address for Communication (with Pin Code) *

Same as Present Address

7. Permanent Address (with Pin Code) *

Personal Details

8. Marital Status *

Married

Widowed

Separated

Divorced

Single

No. of Children

9. Nationality *

Religion

10. Family Details

Name	Relationship	Age (Years)	Occupation	Monthly Income

Do you have any relative working in our company?

Yes

11. Educational Qualification (Give Details from High School)

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

Certificate Attachments

14. Experience Data

Organization Name	Designation Held	Job Details	Area Covered	Achieved Turnover (Lakhs)	Joining Date	Date of Leaving	Last Salary + Perks	Leaving Reason

Previous Company Offer Letter Attachments

15. Reason for leaving the current organization:

Additional Information

16. Have you appeared for Interview before with Jayalakshmi Fertilisers?

Yes

17. Have you ever suffered from any chronic disease? If so, please give details

Yes

18. Have you ever been convicted in the Court of law? If yes, please give details

Yes

19. Compensation & References

20. Present CTC per Annum

Expected CTC per Annum

21. Please mention how much time you require for joining us

22. Please give two industry officials references / Present reporting persons reference:

S.No	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 been 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:

EMPLOYEE APPLICATION FORM

Jayalakshmi Fertilisers

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