Job Application Form Updated

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    07-May-2017

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EMPLOYMENT APPLICATION / PERSONAL PROFILE

Wuerth Group India

EMPLOYMENT APPLICATION / PERSONAL PROFILE

Post Applied for :

Name : Designation :. Dept :

Affix Photo

1. Personal:

1. Date of Birth: Place of Birth:

2. Religion: Caste / Community:

3. Nationality: Sex: Blood Group:.

4. Address for Communication

Phone No.Permanent Address

Phone No.

5. Languages Known (Please tick appropriate column) Read Write Speak

i. (Mother Tongue)..

ii

iii

iv

v.

6. In case of emergency contact

Name..RelationshipTel No

7. Do you know driving: Two Wheeler Four Wheeler None

If yes, driving Licence No.Valid up to

8. Do you own: Two Wheeler Four Wheeler None

9. Do you have a Passport: Yes No

If yes, Passport NoValid upto.

2. Health History:

1. Your blood group: ..

2. Do your wear Spectacles : Yes No

If yes, What power : right eye Left eye

3. Any Known allergies:..

4. Do you suffer from Respiratory Disorder Heart Disease

Blood Pressure Diabetes Asthma

Others Specify:

5. Have you suffered any aliments in the past? Give details.

.

6. Have you had any accident in the past?

3. Family Background:

1. Whether married? Yes No

If yes, furnish date of marriage:..

FAMILY BACKGROUND

Name

(Family members)AgeQualificationOccupationDependentYes / No

4. Educational History: (Starting from 10th Std.)

Name of the

InstitutionFromToExam

PassedSpecial

Subjects% of

Marks

Trainings Attended:

Achievements:

5. A. Employment History Current to Previous

1. Previous ExperienceName & Address of EmployerFrom To (Month/ Year)Dept./

DesignationGross Salary

2. Work Description

3. Your Achievements

4. Reason for Job Shift

5. B. Employment History Current to Previous

1. Previous ExperienceName & Address of EmployerFrom To (Month/ Year)Dept./

DesignationGross Salary

2. Work Description

3. Your Achievements

4. Reason for Job Shift

5. C. Employment History Current to Previous

1. Previous ExperienceName & Address of EmployerFrom To (Month/ Year)Dept./

DesignationGross Salary

2. Work Description

3. Your Achievements

4. Reason for Job Shift

5. D. Employment History Current to Previous

1. Previous ExperienceName & Address of EmployerFrom To (Month/ Year)Dept./

DesignationGross Salary

.

2. Work Description

3. Your Achievements

4. Reason for Job Shift

6. Additional Information On your Present / Latest Employment:

Appointment Dt Reporting to

Your Reportees

Annual Sales turnover

(Per month)

Basic

DA

H.R.A

Conveyance

Other allowance

Specify

Total per month

Total per annum(A)Amt.(Per annum)

LTA

Educational

Bonus

Medical

Other allowance

Specify

Total per annum (B)Amt.Other Benefits

(per annum)

EPF

Gratuity

Superannuation

Others

Total per annum(C)

Gross per annum

(A+B+C)Amt.

7. Other Information:

1. Have you applied to /interviewed by us in the past? Yes No

If yes, please state position applied for.. Interviewed on..

2. Salary Expected:

3. How soon would you been able to join us?

4. Willingness to Re-locate if required? Yes No

5. Do you have any relatives employed in this company? If yes, give details:

6. How did you get to know about the vacancy?

7. Have you ever been convicted under any court of law? If yes, furnish details:

8. WORKING interest

1. a. What is your aspiration in the career?_________________________________________________________________________

_________________________________________________________________________ _________________________________________________________________________

b. Reason for encouraging you to apply to this company?

_________________________________________________________________________

_________________________________________________________________________

c. What is your working program for this company if you are joining?

________________________________________________________________________ ________________________________________________________________________

_________________________________________________________________________

d. Your short term purpose in your career (3 5 years ahead)

________________________________________________________________________

_______________________________________________________________________ ________________________________________________________________________

e. Specific expertise / skills you have (related to the job) ?_________________________________________________________________________

_________________________________________________________________________

2. Write briefly about yourself:

a. What do you expect in your life? _______________________________________________________________________

_______________________________________________________________________

________________________________________________________________________

_________________________________________________________________________

b. What are you principles and life philosophy:______________________________________________________________________

______________________________________________________________________

_______________________________________________________________________

c. What are your strengths and weaknesses?Strengths : _____________________________________________________________ Weaknesses: ____________________________________________________________d. What is the opinion of your friends about yourself (as far as you know)?_______________________________________________________________________

_______________________________________________________________________

e. Please explain your opinion about the difference between duties and responsibilities:_______________________________________________________________________ _______________________________________________________________________

_______________________________________________________________________

f. Tell briefly about your view of the Art of Selling : ______________________________________________________________________________________________________________________________________________

9. Any Civil / Criminal proceedings pending against you in any court of law?

Yes No. If yes please clarify.

References (No relative please) Contact No. & Address1.

2.

References from the Current Employer - Contact No. & Address 1.

2.

Name and Address of person to be contacted in case of Emergency:

1.

2.

Your extra curricular activities, if any please specify

Playing Games ( Specify)..

Cinema TV Reading Books Listening to Music

Stamp Collections Social service Others..

Declaration: I hereby affirm that the foregoing statement and answer to questions are true to the best of my knowledge and belief and without consequential omissions of any kind whatsoever and understand that any wrong statements and suppression of facts will if I am employed, subject me to immediate dismissal.

Date:

Place: Signature

OFFICE USE

Date of Interview __________________ Place of Interview: __________________

Remarks of AM/BM/DM: _______________________________________________________________

Name & Signature: _____________________ _____________________Remarks of RM: ______________________________________________________________________Name & Signature: _____________________ _____________________

Remarks of BDM :_____________________________________________________________________

Name & Signature: _____________________ _____________________

Approvals GM: Approved / Not Approved ______________________________ Remarks if any: _____________________________________________________________________

Name & Signature: _____________________ _____________________

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