APPLICATION FOR EMPLOYMENT

(To be filled by candidate in his/her hand writing)

POSITION APPLIED FOR

Affix Photograph
(Passport Size)

PERSONAL INFORMATION
NAME (in capital)

(Surname) (First Name) (Middle Name)

FATHER'S/HUSBAND'S NAME (in capital)

PRESENT ADDRESS: Contact Nos. Date of Birth:

Resi:

Off: Age:

E-mail:

PERMANENT ADDRESS: MARITAL STATUS PHYSICAL DISABILITY

(IF ANY)

CHILDREN:

Languages known Speak -

(Underline Mother Tongue
Write -
ACADEMIC QUALIFICATIONS:

School/College/University/Insitute YearCertificate/ Grade/

Major Subjects
degree %age
1
2
3
4
5
SHORT TERMS COURSES (Give Details)
SPECILIZED TRAINING/APPRENTICESHIP (Give Details)
 PRESENT EMPLOYMENT
Date & EMPLOYER NATURE OF BUSINESS Position(s) held
Salary on (Name & Address) OF EMPLOYER with period
Joining

DESCRIPTION OF PRESENT DUTIES: TOTAL EMOLUCMENTS (PER MONTH)

(Excluding retirement benefits)
Present (Rs.) Expected (Rs.)

Basic:

Converyance:

House Rent:

TO WHOM DO WHO REPORT TO Leave Travel:

YOU REPORT YOU
Medical:

Other, if any:

Total:
NOTICE PERIOD WHY SEEKING
CHANGE Bonus:

Can you deposit your last salary drawn slip? if no, why?

Are you member of Employees Provident fund/F.P.S Scheme:-

Please give, in Brief, significant contribution made by you in your previous/ present Assignments:

Can we ask about your working from your present employer Yes/No. If no, reasons

Family Back Ground (Father,Mother,Brother/Sister, Wife/Husband, Children etc.)

Sl. No. Relationship Occupation Sl. No. Relationship Occupation
 PREVIOUS EMPLOYMENT
Employer's Name, Address & Position Period Nature of duties Reason for Total emoluments per Month
Nature of Business held From To Leaving the Job (Excluding retirement Benefits)
Starting Leaving
Have you applied to any company dealing with LPG/Auto LPG before ? Yes/No (If yes, give details)

Do you have any relative working in LPG/Auto LPG Organisation:

If the reply of the above is no, then you will be required traning for three months. In case, you are selecting
in Company, will you be in a position to furnish Guarantee of Two Govt. Employee in favour of the
company?

In case of premature quitting by you and non-complience of terms of the company accepted by you, will
you accept the Company's term to refund 50% of the Stipend paid to you during training period?

Do you know driving Vehicles ? (Tick) 2 Wheeler /4 wheeler

Do you have your own Vehicle, if yes, give details.

Are you ready to use your own mobile handset & Laptop for official uses? ( company will provide you Sim/
Data Card) and if you do not have the same, are you ready to but the same at your own cost?

Are you a member of any Professional Association, Club,etc.? (If yes, give details)

If there is any further information which do you think may be helpful in considering your application,
please give details:-

Have you been prosecuted in a Court of Law (If yes, give details)

I hereby certify that all foregoing information is true, complete and correct to the best of my knowledge
and belief. I understand that any misrepresentation or material omission made in this form or any other
documents required by the company renders me liable to termination or dismissal from service & in
that case no stipend will be paid to me.

Date…………………………. Signature

FOR THE COMPANY'S USE ONLY

Interview On : Interview Notes & Recommendation of A.E/ A.M.(Services)

Interview By :

Admin.E/A.M( Service)
Grounds & amount of Salary negotiated
& Tentative Date of Joining

Date: Manager(HR/ Admn.)