Bosch Limited.
PostBox Number 3000, Bangalore – 560 030 Phone 22992111/2222088
Grams: MICODIESEL FAX:22272728
APPLICATION FOR EMPLOYMENT Reference Number:
MANAGEMENT STAFF
1. Answer each column fully
POSITION APPLIED FOR TOTAL INDUSTRIAL GROSS SALARY DATE OF APPLICATION IF SELECTED, WHEN CAN YOU
EXPERIENCE EXPECTED (dd/MM/yyyy) JOIN? (dd/MM/yyyy)
GA2009
Years 0 Months 0
PERSONAL DATA
NAME IN FULL (Surname First, As In The Certificate)
(SPACE FOR RECENT
PHOTOGRAPH TO
SEX DATE OF BIRTH PLACE OF BIRTH BE AFFIXED
MALE (dd/MM/yyyy) DURING THE TIME
OFINTERVIEW)
PLACE STATE
MOTHER TONGUE NATIONALITY MARITAL STATUS RELIGION
SINGLE
SPOUSE’S NAME OCCUPATION
- -
DO YOU BELONG TO SC/ST NO
FATHER’S NAME OCCUPATION
DEPENDENT CHILDREN NO./GENDER NO. OF DEPENDENTS(OTHER THAN SPOUSE AND CHILDREN)
NO.1 NO.2 NO.3 PARENTS OTHERS(SPECIFY)
SEX - SEX - SEX -
BORN (MON-YEAR) BORN (MON-YEAR) BORN (MON-YEAR)
PRESENT ADDRESS PERMANENT ADDRESS
CITY. PIN.
CITY. PIN. STD CODE. E-MAIL
STD CODE. E-MAIL
TEL NO. MOBILE NO. TEL NO. MOBILE NO.
EDUCATION
TYPE OF EDUCATION NAME & LOCATION DEGREE YEAR % OF CLASS/RANK/ MAJOR SUBJECTS
OF INSTITUTION ATTENDED MARK
S
FROM:
SSLC PASS
TO:
HSC/PUC FROM:
PASS
TO:
FROM:
COLLEGE/GRADUATION
TO:
FROM:
PROFESSIONAL 1
TO:
FROM:
PROFESSIONAL 2
TO:
TRAINING
NAME & LOCATION DURATION
OF FROM TO NATURE OF TRAINING
INSTITUTION (Project, placement, etc.)
MONTH YEAR MONTH YEAR
EXPERIENCE
NAME & ADDRESS
OF PERIOD EMPLOYED GROSS
EMPLOYER POSITION, TITLE, SALARY
(Begin with current employer TYPE OF WORK & DRAWN
and REASON FOR LEAVING PER
FROM TO
wherever there are gaps MONTH
explain)
MONTH YEAR MONTH YEAR
01 01 POSITION :
TITLE :
TYPE OF WORK :
REASON FOR LEAVING :
01 01 POSITION :
TITLE :
TYPE OF WORK :
REASON FOR LEAVING :
01 01 POSITION :
TITLE :
TYPE OF WORK :
REASON FOR LEAVING :
01 01 POSITION :
TITLE :
TYPE OF WORK :
REASON FOR LEAVING :
ARE YOU UNDER ANY BOND TO AN EDUCATIONAL MAY WE COMMUNICATE WITH YOUR PRESENT EMPLOYER? YES
INSTITUTE, PAST OR PRESENT EMPLOYER? No
SPECIFY AMOUNT, IF ANY : Rs. 0
INTERESTS
ACHEIVEMENTS IN SPORTS, LITERARY ACTIVITIES, ETC. :
HOBBIES & SPECIAL INTERESTS :
MEMBERSHIP OF PROFESSIONAL ASSOCIATIONS :
PAPERS PUBLISHED, IF ANY :
1. Please provide your current (a) job responsibilities (b) department organisation structure (c) the number and designation of people you supervise
and (d) the person you report to.
(a)
(b)
(c)
(d)
2. What are your career objectives ?
3. Any other information you would like to give.
Please furnish your present remuneration details. Date of last salary revision :
Date of next salary revision :
Compensation Element Amount (Rs) REMARKS
MONTHLY :
Basic Salary 0
Dearness Allowance 0
House Rent Allowance 0
Conveyance Allowance 0
City Compensatory Allowance 0
Children’s Education Allowance 0
Incentive 0
Other perquisites in cash or kind (Specify details) 0
Sub Total 1 0
ANNUAL :
(Indicate compensation per annum)
Leave Travel Allowance 0
Medical 0
Bonus / Ex. Gratia 0
Other perquisites in cash or kind (Specify details) 0
Sub Total 2 0
RETIRALS :
PF
0
Gratuity 0
Superannuation 0
Sub Total 3 0
TOTAL(Annualised)
(Sub Total 1 + Sub Total 3) x 12 + Sub Total 2) 0
DEDUCTIONS / RECOVERIES, IF ANY
0 0
DO YOU STAY IN OWN HOUSE
RENTED/LEASED HOUSE RENT PER MONTH 0
ANY OTHER (Please give details)
LANGUAGE
LANGUAGE
PROFICIENCY
CAN SPEAK
CAN READ
CAN WRITE
HEALTH
HEIGHT (CMS) WEIGHT (KGS) BLOOD GROUP VISION PHYSICAL HANDICAPS, IF ANY
R L
MOST RECENT ILLNESS FROM TO NATURE OF ILLNESS
no
CHRONIC ILLNESSES IF ANY (High blood pressure,diabetes,etc) MAJOR SURGICAL OPERATIONS, IF ANY
REFERENCES
FRIENDS / RELATIVES EMPLOYED IN BOSCH(Including ex-employees of Bosch)
NAME DESIGNATION RELATIONSHIP
CHARACTER / EMPLOYMENT REFERENCES (Preferably persons closely associated with your education/work experience; exclude relatives and
Bosch Employees)
NAME PROFESSION / DESIGNATION MAILING ADDRESS
MOBILE. E-MAIL
MOBILE. E-MAIL
ARE YOU A MEMBER OF ACCOUNT NO.
EMPLOYEES’ PROVIDENT FUND SCHEME (EPF) No
EMPLOYEES’ FAMILY PENSION SCHEME No
EMPLOYEES’ STATE INSURANCE SCHEME (ESI) No
GENERAL
HAVE YOU EVER BEEN CONVICTED FOR A CRIME OR IS THERE A CRIMINAL CASE PENDING AGAINST YOU? No
IF YES PLEASE SPECIFY
HAVE YOU APPLIED TO BOSCHBEFORE? No
IF YES PLEASE SPECIFY
INDICATE LOCATIONAL PREFERENCE/CONSTRAINTS, IF ANY
CONTACT PERSON IN CASE OF EMERGENCY (Preferable local)
NAME ADDRESS
RELATIONSHIP
TEL NO.
By filling this application, I certify that the statements made by me above are true, complete and correct. I agree that in case the Company finds at
any time, the information given by me in this application form is not correct, true or complete, the Company will have the right to withdraw,
if selected, the Letter of Appointment before I join services or to terminate my appointment at any time without notice or compensation
after I have taken up service.
PLACE : DATE : SIGNATURE :
Please fill up incase application is sent through consultant.
Name of the Consultant:
E-MAIL ID :
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