APPLICATION FOR EMPLOYMENT

Thank you for your interest in Wipro. This form is intended to enable you to record important points
about yourself, your experience, your achievements and your plans for the future. Please complete
the form in full and use additional sheets if necessary. When we meet you at the interview, the
contents of this application will provide a base for our interaction.

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 Kindly affix a
PERSONAL INFORMATION Passport size
Photograph
First Name Middle Name Last Name Her
Mr/Ms
( Expand all names)
Date of Birth
e-mail :
d d m m y y y Y
Current Address :

City State PIN Offic

Phone (with
e
STD code)
Res.
Permanent Address :

City State PIN Phone(with STD

code)
Mobile

EDUCATION
(Begin with the most recent qualification and end with Std. X)
Course/Degree Specialization Name of Institute Address Graduatio Aggregate
/University n Marks
(Month/Yr. (% or CGPA)
)

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

WORK EXPERIENCE
Number of Companies Worked for (Count should include the Present Employer)

CURRENT EMPLOYMENT
Name of the Employer Address :

Number of Employees Sales Turnover

Phone :

Date Employed From To Notice Period :

Your Designation & Department Employee Responsibilities
Code

Reason For Leaving

Supervisor’s Name & Designation, EMAIL ID & Contact Number

Can we take reference from your supervisor? 
Yes  No

Deputation Details :( Mention name of organization to whom you were deputed

through current employer Please mention NA if not applicable)

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MONTHLY EMOLUMENTS
Fixed Salary Variable / Perks Deferred benefits
PF, Pension, Gratuity etc.
Basic Housing
(C)

Bonus/Incentives Company car

Allowances Furnishings Monthly Gross (A+B+C)

Others
(please specify) Others
Current Annual Gross
(please specify)

Expected Annual
Total (A) Total (B)
Gross

Do you have employee stock options?  Yes If yes, Nett gain at current value :
No
 {(Current Market Price – Issue price) x No. of stocks}
PREVIOUS EMPLOYMENT
Name of the Employer Address :

Phone :
Dates Employed FROM TO

Your Designation & Department Employee Responsibilities

Code

Reason For Leaving Monthly Gross: -

Supervisor’s Name & Designation, EMAIL ID & Contact Number

Deputation Details :( Mention name of organization to which you were deputed through
current employer. Please mention NA if not applicable)

ALL OTHER PREVIOUS EMPLOYMENT DETAILS

Name of the organization Location Designatio Employe Duration Monthly Salary Reason for
n e Code From To Starting Final Leaving

ABOUT YOURSELF
The answers to the following questions will help us get a better understanding of you as a person.
Your personal strengths? Your personal areas of improvement?

Your career objectives? Your expectations from the job/Wipro?

SIGNIFICANT ACHIEVEMENTS: Distinctions, Honors, Awards ( Academic/extra curricular ) received

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

REFERENCES
Give references under whom you have either worked or who know you professionally for at least 6 months.
Name Duration & Organization & Designation e-mail Phone (with STD code)
Nature of Home Office
Association

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 Off:
Per:

Off:
Per:

Off:
Per:

ADDITIONAL DETAILS
If Others, Specify Nationality :
Nationality  Indian  Others
Do you have work permit to work in India?  Yes
 No
Do you hold a valid Passport? Yes If Yes, Passport No :
No
(for Indian citizens only) Valid till :
If Yes, Details
Have you been denied VISA to any country? Yes
No
If yes, provide details on countries visited and type of Visas
Have you worked on overseas assignments? Yes held
No

Have you attended any selection process at Yes If Yes, Division : Location :
No
Wipro before? Month/Year: Status :
Do you have any relative / friend employed If Yes, his/her name :
With Wipro? Yes Division/Location :
No
Have you suffered from any major illness If Yes, Details
/surgery /accident in the last five years? Yes
No
Have you ever been arrested, prosecuted or convicted for any If Yes, furnish details including type of offense and
criminal offense, other than minor traffic offenses ? conviction
Yes No
In the last ten years, have you been convicted of or plead guilty Yes ( ) NO ( )
to any offence?
In the last ten years have you been released from prison on a Yes ( ) NO ( )
conviction?
Do you have any commitment to another employer or organization that might affect your employment with us? Yes
No
Any other information you would like us to know which may have significant bearing on our hiring decision :

WORK LOCATIONS
Are you willing to be posted anywhere in India? Yes
Are you willing to be posted abroad? Yes No
No
Indicate your preferred work location in India

DECLARATIONS
1. I hereby declare that my statements on this form and on my resume or documents provided by me to Wipro are true and
correct to the best of my knowledge.
2. I understand that Wipro, at its discretion, may institute and conduct a background check to verify the information furnished by
me in this form. Wipro assures me that background check on my current employment will be taken up only post my joining
Wipro and this is acceptable to me.
3. I authorize all persons who may have information relevant to the verification to make disclosures to Wipro or its
representatives/ agents.
4. 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.
5. I understand that Wipro may notify and publish any information provided by me that is found false. In addition, I understand
and agree that Wipro has rights to seek any legal remedies including indemnification and damages from me for any loss
caused to Wipro as a result of any such false information.

Date: Place: Name:

Signature:

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