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Godrej & Boyce Mfg. Co. Ltd.

APPLI C AT I O N

FORM

Recent
Photograph (in
professional
attire)

POST APPLIED FOR : _______________________________

FULL NAME

: Mr. / Ms. __________________________________________________________________

( Surname )
(First Name )
( Middle Name)

ADDRESS FOR COMMUNICATION (Local)

PERMANENT ADDRESS ( Native Place)

Mobile No.:
E-mail ID

Phone :

DATE OF BIRTH : ___ / ___ / _______ PLACE OF BIRTH :_______________NATIONALITY :_____________

DO YOU BELONG TO: SC ______ ST _____ OBC _____ OTHERS ______
LANGUAGES KNOWN : ( Communication Skills )
Languages

Speak

Read

Write

EDUCATIONAL QUALIFICATION:
Qualification
(Starting from
SSC)

Full-time /
Part-time or
Corres.

Duration of Course
From
MM/YY

To
MM/YY

Month &
Year of
Passing

Name & Location of

School/College/Usity/Board
(City & State)

Class /Grade &

Percentage
of marks

Was there any break in your studies? No / Yes (If yes, please mention the reason for the same)
_____________________________________________________________________________________________________
KNOWLEDGE OF COMPUTERS: _____________________________________________________________________
Contd. ( 2 )

WORK EXPERIENCE: (- Including practical training, if any.

- Please write in chronological order ending with present employment)
Period
From

To

(DD/MM/
YY )

(DD/MM/
YY)

Experience
( in
months )

Name & Location of

Employer / Self Employment

Designation and
Nature of Work

Annual
Cost to
Company

Reasons
for
Leaving

BREAKUP OF THE PRESENT / LAST SALARY, BENEFITS & PERQUISITES :

Components
Monthly Benefits
Basic Salary
House Rent Allowance
Medical Expense Reimbursement

Rs. ( p.m.)

Components
Annual Benefits

Rs. (p.m.)

Leave Travel Allowance (LTA)

Mediclaim / Hospitalisation Insurance
( Coverage Amount Rs. __________)
Any Other

Education Allowance
Lunch / Canteen

TOTAL ( B ) :

Conveyance Allowance
Telephone Expense Reimbursement

Terminal Benefits

Other Allowances:

a)

Provident Fund

b)

Gratuity

c)

Superannuation

d)

Any Other

TOTAL ( A ) :

TOTAL ( C ) :

Cost to Company ( p.a.) : ( A + B + C ) X 12 Rs. ________________ /-

PAN Card No. : ______________________

Expected Remuneration : Monthly Gross : Rs. _____________ Cost to Company ( p.a.) : Rs. ________________
REFERENCES : ( Name of the relatives / acquaintances in any of the Godrej establishments )
Name

Division/Plant, Department & Location

(Specify State & District )

Relationship with
the applicant

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Contd ( 3 )

SOURCE OF RECRUITMENT (DETAILS OF YOUR INTRODUCTION TO US):

Self / Placement Consultant / Advertisement (Newspaper / Godrej Website / Any other Job Portal) / Campus Interview /
Employee Reference / Job Fair / Walk-in / Employees Son / Daughter / Ex-Trainee (Summer / Project / In-Plant) / Temp. Staff.
Please mention the exact detail here: ____________________________________________________ (For example, if you are
referred by a Placement Consultant, please mention the name of the Firm / Agency).
Please explain in brief why you consider yourself suitable for the position applied for ?
a)

____________________________________________________________________________________

b)

____________________________________________________________________________________

c)

____________________________________________________________________________________

Which functional area do you prefer ? ________________________________________________________

( List in order of preference. E.g. Sales, Service, Production, Quality Control, Design, Maintenance etc)
Are you planning for higher studies ? If yes, please specify _______________________________________
Weekly off day(s) in your present employment : _______________________________________________
Have you been previously tested / interviewed by us ? If yes, state when & for what post ? Yes / No

_________________________________________________________________________
How soon would you be able to take up the new appointment, if selected ? _______________________
DECLARATION
I declare that the foregoing information is correct and complete to the best of my knowledge and belief and nothing has been concealed.
I accept that the statement made by me and the information supplied by me shall form the basis of my employment / traineeship with
the Company. If at any point in time in future, I am found to have concealed any material information or given false details against any
of the above particulars, my appointment / traineeship shall be liable to summary termination without notice or payment in lieu of
notice.

Date

: ___/ ___/ ________

_________________________

Place : ________________

(Signature of the Applicant)

Note:
1.

If appointed, you are liable to be posted and/or transferred to any of the Companys Establishments
within the Territories of India.

2.

All appointments are subject to the candidate being declared medically fit by the Companys Medical
Officer or a Medical Practitioner of Companys choice. The Managements decision in this regard is final.
(For office use only)

GI Raw ________ GI Stanine _________ MC Raw _______ MC Stanine ________ Written English: __________
1-2-3 Raw ____________________ 1-2-3 Stanine ___________________________ 16 PF _____________________
Date of Test: ___________________ Conducted by: _______________________ Signature: ____________________
Special approval (if any) by Head - HR _______________________________________________________________