Application For Employment

(for ‘M’ & ‘S’ cadre)

1.	Full Name

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2. Who has referred you for employment

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3. Do you have any relative(s) working at any unit of PSL Group Companies, (if yes give details) YES NO

Relative’s Name	Relationship	Designation	Location

4.	Postal Address	a) PRESENT (for correspondence)	b) PERMANENT
House No./Street Village
Taluka/Thana/P.O
City/District
State/Pin Code
E-mail ID
Phone No. (with STD code)
5. Date of Birth	/	/	6. Nationality

7. Gender: Male Female 8. Marital Status: Single Married Divorced

9. Health Rating: Excellent Good Fair Poor 10 Blood Group:

11.	Identification Mark(s)

12. Family

Name	Age (Yrs.)	Qualifications	Occupation
Father :
Mother :
Spouse :
Children 1.
2.
3.

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13. LANGUAGE PROFICIENCY: (Mother-tongue first)

( ( Tick the appropriate box)

Language(s)	Speak	Read	Write	Understand only

14.	REFERENCES: Please give reference of 2 responsible persons who know you for more than 3 years and can vouch for your character, conduct and behaviour. One can be of your relation.

Name & Status / Designation	Complete Postal Address	Phone No.

15. TRAINING PROGRAMMES/SHORT TERM COURSES, if any (In chronological descending order):

Programme	Name & Complete address of Institute	Programme	Proficiency certificate
Duration	Year of completion

16. What kind of a job are you looking for? Please spell out.

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17. ACADEMIC QUALIFICATIONS: (In descending scholastic order ie., Masters/Bachelors/etc.,)

Name and complete address of Institution	Name & Complete Address of Board/University	Examination Passed	Study Period	%age Marks
From	To
MM	YY	MM	YY

18. WORK EXPERIENCE (In chronological descending order) :

Name & Complete address of Employer	Position held at the time of	Kind of job you were involved in	Gross salary at the time of Leaving
Joining	Date	Leaving	Date

19. CURRENT GROSS SALARY PER MONTH: (This must be substantiated by authenticated documents during interviw)

Basic	Allowances & Other Benefits	Employees Contribution towards PF, Pension etc.,	Gross

20. Gross salary expected:
21. When can you join, if selected (date):

22. Any other information you would like to give, which you feel could influence your candidature:

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PSL

Space for Passport photo to be pasted later

User

2011-03-12