JOB APPLICATION FORM

Private & Confidential

Please fill in all the spaces provided. If details are not applicable, please write N/A.
Please attach photocopies of certificates and testimonials.
(A) POST APPLIED FOR

BDM

POSITION NATURE: *Contract / Permanent

(B) PERSONAL PARTICULARS

*Delete as appropriate

1. Title: Miss

12. Email Address:

gomathishruthi@gmail.com

2. Full Name (Underline Surname): Shruthi

Sankaranarayanan Gomathi

13. Address:

F-2, 4/441, Vaishali Sec-4,

Ghaziabad, U.P. 201010

3. Marital Status:*Single
4. ID Type: *PAN / Passport /
Others (Please state: PAN
5. PAN No.:

14. Correspondence address outside Singapore (if applicable):

BEKPG5492M

6. India Permanent Resident: *Yes

7. Present Citizenship: Indian

15. * Last / Current Employer:

8. Date of Birth: 04/10/1990

Mastech Solutions Pvt Ltd

9. Gender: F

16: * Last Drawn / Current Monthly Gross Salary (INR):

10. Race: Asian

11. Tel No.: 0120-2773698

9582231430

Rs 25,000
(Home)

17. Expected Monthly Salary (INR): Rs 30,000

(Handphone)

18. Earliest date of starting work if offered appointment (e.g.

immediately, within one month):
Immediately

(C) EDUCATIONAL QUALIFATIONS

Name in chronological order the schools attended
School / Institution and Country

ST. THOMAS SCHOOL, INDRAPURAM

TS NARAYANASWAMY COLLEGE OF
ARTS AND SCIENCE
MOP VAISHNAV COLLEGE FOR WOMEN

Year of
Joining

Year of
Leaving

Highest Qualification Attained

2005
2009

2009
2012

10TH & 12TH

BCOM

2012

2014

MBA

(D) PREVIOUS & PRESENT EMPLOYMENT (IN CHRONOLOGICAL ORDER)

From
(date)
August14

Organization Name
Mastech Staffing Solutions Pvt Ltd

To
(date)
October14

Designation

Reasons for Leaving

Junior Recruiter

Night shifts

(E) PROFESSIONAL QUALIFICATIONS / MEMBERSHIPS

Name of Association / Society

Period (MM/YY MM/YY)

Membership Status / Position

(F) PARTICULARS OF PARENTS / SPOUSE / CHILDREN

Full Name

Relationship

Employer

Occupation

A.H. Sankaranarayanan
Subha Shankar
Hari Sreyas

Father
Mother
Brother

Government
Goverment
Stellium

Service
Service
IT Professional

(G) CHARACTER REFEREES

(Please provide particulars of two persons who are not related to you. They should be responsible persons who know you well with
regard to your character and work performance. We may contact either or both of the referees stated prior to job offer).

Full Name:Lalitha Balakrishnan

Title:Principal

Employer:MOP Vaishnav College for women

Tel No.:09940557437
Email Address:doctorlalitha@gmail.com

Designation:Principal

Years Known:2

Full Name:Anuradha Prashanth

Title:Lecturer

Employer:MOP Vaishnav College for women

Tel No.:9840298649
Email Address:anuradha.prashant@yahoo.com

Designation:HOD

Years Known:2

(H) PLEASE ANSWER THE FOLLOWING QUESTIONS BY DELETING YES OR NO AS

APPROPRIATE. FOR ANY YES ANSWERS, PLEASE PROVIDE DOCUMENTARY EVIDENCE
1. Have you ever suffered, or are suffering from any medical condition, illnesses, disease, mental
* No
illness or physical impairment?
2a. Do you have a criminal record in India? (By this, we refer only to a criminal record of a
conviction under the Registration of Criminals Act)

No

b. Have you ever been convicted in a court of law in any country?

No

3. Have you been charged with any offence in a court of law in India or in any other country
for which the outcome is pending?

No

4. Has there been any Statutory Demand currently served on you or legal proceedings commenced
No
against you?
5. Have you been or are you under any financial embarrassment i.e. (a) an undischarged bankrupt,
No

(b) a judgement debtor, (c) have unsecured debts and liabilities of more than three months of
last-drawn pay, (d) have signed a promissory note or an acknowledgement of indebtedness?
6. Have your services ever been terminated by your previous employers?

No

7. Did you ever leave an employer without serving out a period of moral obligatory service (e.g.
resulting from no-pay leave taken or training)?

No

8. Have you ever been issued any licence in the course of your employment by any regulatory
body?

No

9. Are you related to any of our staff members?

No

If you answer was Yes to any of the questions above, please give details

(I) CONFLICT OF INTERESTS

Are you aware of any personal relationship that might cause a potential conflict in this job?

No

If yes, please give details.

(J) DECLARATION
I give my consent for the above company to obtain and verify information from or with any source, as you
deem appropriate for the assessment of my application for employment.
I declare that all information given by me in this application for employment and any sheets attached hereto
are true to the best of my knowledge and I have not willfully suppressed any material fact. I accept that if any
of the information given by me in this application is in any way false or incorrect, my application may be
rejected, any offer of employment may be withdrawn or my employment with iFAST Corporation Pte Ltd may
be terminated summarily or I may be dismissed.
Signature of Applicant: SHRUTHI. S.GOMATHI
Date:

17/11/2014

LETTER OF AUTHORIZATION

To Whom It May Concern

I Shruthi Sankaranarayanan Gomathi

(Name as in PAN/Employment Pass/Passport)

hereby irrevocably and unconditionally authorize you to perform reference checks of my

previous employment(s) and release from liability all persons or entities requesting or
supplying such information.

Shruthi . S. Gomathi
Signature

BEKPG5492M
PAN/Employment Pass/Passport No.

17/11/2014
Date