EMPLOYMENT APPLICATION FORM

PERSONAL INFORMATION
Kindly affix a
First Name Middle Name Last Name
Passport size
Mr./Ms
Photograph

Date of Birth e-mail:

City: PIN Office

Phone (with
State:
STD code) Res.

PIN Phone (with STD code)

City: State:
Mobile
Father’s / Husband’s Name:

Father’s / Husband’ Occupation details:

DETAILS OF DEPENDENTS:
Name Age Relationship Occupation

EDUCATION (Begin with the most recent qualification and end with Std. X)
Name of Institute /University Graduation Aggregate Marks
Course/Degree Specialization Location
(Month/Yr.) (% or CGPA)
ABOUT YOURSELF
The answers to the following questions will help us get a better understanding of you as a person.
Your personal strengths Significant Achievements

Learning objectives for next 3 – 5 years Your expectations from Athaang Infrastructure Pvt.Ltd including role, career
growth, etc.

Your intended contribution to Society Any family constraints

OTHER INTERESTS: Cultural, sports, community work and hobbies from school onwards & details of memberships of association Sports

WORK EXPERIENCE
PRESENT / LAST EMPLOYMENT
Name & Address of the Employer: Employed from:

To
Your Designation at the time of joining the Your Current Designation: Reason for Seeking Change
organisation:

Role & Responsibilities

PREVIOUS EMPLOYMENT DETAILS

Name of the organization Location Designation Duration Monthly Salary Reason for Leaving
At the At the From To Starting Final
time of time of (in DD/ (in DD/
joining leaving MM/ MM/
YYYY) YYYY)

SALARY DETAILS
 Fixed Salary (Monthly) Variable / Perks (Annual) Retiral Benefits
Basic Bonus / PLR PF

Gratuity etc.
HRA Company car

Conveyance LTA Pension

Allowances
Location based Others Total (C)
Allowances (please specify)
Superannuation Others Total (A) + (B) + (C)
(please specify) =
Any Other Allowances Others Any Reimbursements
(please specify) (please specify) (medical, uniform,
etc.)
Total (A) Total (B) Current Annual Gross

Total Monthly Total Annual Expected Annual

Emoluments Emoluments Gross

If yes, Nett gain at current value :

Do you have employee stock options? Yes No  {(Current Market Price – Issue price) x No. of stocks}

TRAINING
Dates attended
Training/Development Programs attended / IT Skills acquired Institute / Organization Location
From To

ADDITIONAL DETAILS
Nationality If Others, Specify Nationality :

Do you have work permit to work in India? Yes No

Do you hold a valid Passport?
(for Indian citizens only)
If Yes, Division : Location :
Have you attended any selection process?
Athaang or NIIF before?
Month/Year: Status :
If Yes, his/her name :
Do you have any relative / friend employed Division/Location :
Within Athaang or NIIF or its Subsidiaries Designation :
How are you related :
Do you have any relative as a Director of Athaang Infrastructure Pvt.Ltd? If Yes, his/her name :
Name of the Company:

If Yes, Details
Have you suffered from any major illness
/surgery /accident in the last five years?
Language Proficiency
English Hindi
______________________________ Read Write Speak ______________________________ Read Write Speak
Bengali
______________________________ Read Write Speak ______________________________ Read Write Speak
OPTIONAL
If selected ‘Yes’, please provide the details :
Differently Abled Yes No

Ex-servicemen Yes No

Caste General

Religion Hindu
Have you ever been arrested, prosecuted or convicted for any criminal offense, other than If Yes, furnish details including type of offense and
minor traffic offenses ? conviction
In the last ten years, have you been convicted of or plead guilty to any offence?
In the last ten years have you been released from prison on a conviction?

Do you have any commitment to another employer or organization that might affect your employment with us?

Any other information you would like us to know which may have significant bearing on our hiring decision :

REFERENCES
Give references under whom you have either worked or who know you professionally for at least 12 months.
Name Duration & Organization & Designation e-mail Phone (with STD code)
Nature of Home Office
Association
Off:

Per:

Off:

Per:

Off:

Per:

I hereby declare that my statements on this application and on my resume or documents provided by me to Athaang Infrastructure Pvt.Ltd are correct to the best of
my knowledge. I acknowledge and agree that providing any false information may result in a decision not to hire me or if hired, may result in termination of my
employment. I give consent to Athaang Infrastructure Pvt.Ltd to institute and conduct a background check to verify the information furnished by me in this form.

Date: Place: Signature:

FOR OFFICE USE ONLY

HOD ASSESSMENT:
 Assessment Rating A++ A+ A B+ B

Date: _____________________________ Signature: ________________________________

RECOMMENDATION / ENDORSEMENT BY TOP MANAGEMENT:

Date: _____________________________ Signature: ________________________________

HR RECOMMENDATION:

Date:_____________________________ Signature: ________________________________