Robert Bosch Engineering and Business Solutions Limited
Application for Employment
(Recent Passport Size
Position applied for Location Date (dd/mm/yyyy) Photograph To Be Affixed
During The Time Of
Interview)
General Instruction
Type or print this application form ; Specify all dates using DD/MM/YYYY format ; If not hand written,
sign at the bottom of each page
Personal Information
First Name Middle Name Last Name
Date of birth (dd/mm/yyyy) Gender E-Mail ID
Place of Birth: City & State Mother Tongue Nationality Religion
Change of Name if Applicable (Former Name / Maiden Name ) Date of Name Change
Date of Issue Valid till
Passport Number Place of Issue ECNR
(dd/mm/yyyy) (dd/mm/yyyy)
Any ID issued by a competent Government or other agency? (Driving licence, passport, PAN card, Phone bill, Bank passbook others) :
If yes, Please attach photocopy of anyone document.
Current Address
Door No. House Name
Street
Landmark
City State Pin
Residence phone with STD Mobile Number
Permanent Address : Same as Above
Door No. House Name
Street
Landmark
City State Pin
Residence phone with STD Mobile Number
Domiciliary state Period of stay
Family Information
Marital Status Date of Marriage (dd/mm/yyyy) :
Spouse’s Name - First Middle Last Occupation
No. of dependents (Other
Number of children
than Spouse & Children)
Father’s Name - First Middle Last Occupation
Mother’s Name - First Middle Last Occupation
KG Campus, No.363, Thudiyalur Road, Saravanampatti, Coimbatore – 641035, India 1
Telephone: +91 422 663 4000 Telefax : +91 422 663 4104
Registered Office : 123, Industrial Layout, Hosur Road, Koramangala, Bangalore – 560 034, India
Robert Bosch Engineering and Business Solutions Limited
Education (Begin with the highest education qualification & end with class X; Attach legible photo copies of Mark sheets / Degree
Certificate / Provisional Degree Certificate)
Year of passing
Name of Institute / (Month / Year) % of Class /
Course / Degree Location Specialization
University Marks Rank
From To
Post Graduation
Graduation
Diploma
Pre-University /
12th Std
School / 10th Std
Others
Please provide additional information for Post Graduation
Post Graduation I SEM II SEM III SEM IV SEM V SEM VI SEM Aggregate
Percentage
Backlogs
Please provide additional information for Graduation
Graduation I SEM II SEM III SEM IV SEM V SEM VI SEM VII SEM VIII SEM Aggregate
Percentage
Backlogs
Please provide additional information for Diploma
Diploma I SEM II SEM III SEM IV SEM V SEM VI SEM Aggregate
Percentage
Backlogs
KG Campus, No.363, Thudiyalur Road, Saravanampatti, Coimbatore – 641035, India 2
Telephone: +91 422 663 4000 Telefax : +91 422 663 4104
Registered Office : 123, Industrial Layout, Hosur Road, Koramangala, Bangalore – 560 034, India
Robert Bosch Engineering and Business Solutions Limited
Professional Work Experience (Present / Last Employment)
Company Name Key job responsibilities
Building No. Street
Landmark
City State Pin
Employee ID
Current Designation & Department
Date of joining
Reason for seeking change Last drawn salary
Supervisor’s Name & Designation
Supervisor’s Direct Number & Mail Id
Type of employment
Are you under any bond?
If yes, specify bond period or amount / period
Can the employer be contacted now? If No, then provide an alternate date to contact
Reporting structure
Professional Work Experience (Past Employment)
1. Name of the company Key job responsibilities
Building No. Street
Landmark
City State Pin
Date of joining & Leaving
Duration of employment Last drawn salary
Reason for seeking change
2. Name of the company Key job responsibilities
Building No. Street
Landmark
City State Pin
Date of joining & Leaving
Duration of employment Last drawn salary
Reason for seeking change
Please use additional sheet (annexure I) if space is not sufficient.
Technical & Domain skills (List skills which relate to the position applied for & rate them as per scale defined)
1 – Basic Awareness; 2 – End user; 3 – Require guidance; 4 – Can deliver independently; 5 – Ability to train / guide others
KG Campus, No.363, Thudiyalur Road, Saravanampatti, Coimbatore – 641035, India 3
Telephone: +91 422 663 4000 Telefax : +91 422 663 4104
Registered Office : 123, Industrial Layout, Hosur Road, Koramangala, Bangalore – 560 034, India
Robert Bosch Engineering and Business Solutions Limited
Skill Description Self Evaluation
Training / Development Program / Certification (Specify date in dd/mm/yyyy format)
Program Name & Location of Institution Details From To
REFERENCES
Details of persons under whom you have either worked or who know you professionally for at least 6 months
Organization & Nature of Phone No. (With STD Code)
Name Duration E-Mail ID
Designation Association Residence Office
Details of friends / relatives employed in BOSCH
Organization & Nature of Phone No. (With STD Code)
Name Duration E-Mail ID
Designation Association Residence Office
KG Campus, No.363, Thudiyalur Road, Saravanampatti, Coimbatore – 641035, India 4
Telephone: +91 422 663 4000 Telefax : +91 422 663 4104
Registered Office : 123, Industrial Layout, Hosur Road, Koramangala, Bangalore – 560 034, India
Robert Bosch Engineering and Business Solutions Limited
Additional Details
Professional Achievement
Membership of
Professional Association
Research Papers / Articles
published
Patents / License
Registered
Interests
Achievements in Sports,
Literary activities etc.
Awards received
Hobbies & Special
Interests
Health
Height (Cm) Weight (Kg) Blood Group Physical handicaps, if any, please provide details
Have you suffered from any major illness / Surgery / accident in the last
five years? If yes, please provide details
Chronic illness if any (high blood pressure, diabetes, etc)
Information on major surgical operations if any
Information on most recent illness, if any
Statutory Membership Account Number
Are you a member of Employees’ Provident Fund Scheme (EPF)?
Are you a member of Family Pension Scheme (EPS)?
Are you a member of Employees’ State Insurance Scheme (ESI)?
Contact person in case of emergency (preferably local) :
Name
Door Number Relationship
House Name
Street
Landmark
City State Pin
Residence phone
Mobile Number
with STD
KG Campus, No.363, Thudiyalur Road, Saravanampatti, Coimbatore – 641035, India 5
Telephone: +91 422 663 4000 Telefax : +91 422 663 4104
Registered Office : 123, Industrial Layout, Hosur Road, Koramangala, Bangalore – 560 034, India
Robert Bosch Engineering and Business Solutions Limited
Language Proficiency
Language
Can Speak
Can Read
Can Write
Other Details
Have you been interviewed by Bosch before?
If yes, provide details (Division / Location / Month / Year)
Have you ever been arrested, prosecuted or convicted for any
criminal offence, other than minor traffic offences If Yes, provide details
Social security no. / any ID no. issued by competent Government
office If Yes, specify the details
Do you have any commitment to another employer or organization
that might affect your employment with us? If Yes, provide details
Any other information you would like us to know which may have significant bearing on our hiring decision?
If Yes, provide details
Certification by Candidate
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 provided 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 the services or to terminate my appointment at any time without notice or compensation
after I have taken up service.
I authorize ‘Robert Bosch Engineering & Business Solutions Ltd.’ or its agency to verify my credentials. I will cooperate and facilitate
the process of verification of my credentials / antecedents.
Name of the applicant Date Place Signature
KG Campus, No.363, Thudiyalur Road, Saravanampatti, Coimbatore – 641035, India 6
Telephone: +91 422 663 4000 Telefax : +91 422 663 4104
Registered Office : 123, Industrial Layout, Hosur Road, Koramangala, Bangalore – 560 034, India
Robert Bosch Engineering and Business Solutions Limited
Remuneration Details : Annexure II
KG Campus, No.363, Thudiyalur Road, Saravanampatti, Coimbatore – 641035, India 7
Telephone: +91 422 663 4000 Telefax : +91 422 663 4104
Registered Office : 123, Industrial Layout, Hosur Road, Koramangala, Bangalore – 560 034, India
Robert Bosch Engineering and Business Solutions Limited
Name:
Please furnish your present remuneration details. Date of last salary revision:
Date of next salary revision:
Compensation Element Amount (Rs.) Remarks
1. Cash components per month:
Basic Salary
Dearness Allowance
House Rent Allowance
Conveyance Allowance
Children’s Education Allowance
Special Allowance
Other Perquisites
Gross Salary per month
2. Retirals:
PF
Gratuity
Superannuation
Total Per month
3. Cash components per annum:
Incentives
Bonus
LTA
Other Perquisites
Total
CTC ((1+2) X 12 +3 )
Deductions / Recoveries, if any
CTC Per Annum
Expected CTC Per Annum
I certify that the particulars furnished by me are correct.
Date : Signature
Note: Please attach a copy of last drawn salary slip / other endorsement in support of the above particulars.
Professional Work Experience (Annexure I)
3. Name of the company Key job responsibilities
KG Campus, No.363, Thudiyalur Road, Saravanampatti, Coimbatore – 641035, India 8
Telephone: +91 422 663 4000 Telefax : +91 422 663 4104
Registered Office : 123, Industrial Layout, Hosur Road, Koramangala, Bangalore – 560 034, India
Robert Bosch Engineering and Business Solutions Limited
Building No. Street
Landmark
City State Pin
Date of joining & Leaving
Duration of employment Last drawn salary
Reason for seeking change
4. Name of the company Key job responsibilities
Building No. Street
Landmark
City State Pin
Date of joining & Leaving
Duration of employment Last drawn salary
Reason for seeking change
5. Name of the company Key job responsibilities
Building No. Street
Landmark
City State Pin
Date of joining & Leaving
Duration of employment Last drawn salary
Reason for seeking change
6. Name of the company Key job responsibilities
Building No. Street
Landmark
City State Pin
Date of joining & Leaving
Duration of employment Last drawn salary
Reason for seeking change
Name:
Date: Signature
KG Campus, No.363, Thudiyalur Road, Saravanampatti, Coimbatore – 641035, India 9
Telephone: +91 422 663 4000 Telefax : +91 422 663 4104
Registered Office : 123, Industrial Layout, Hosur Road, Koramangala, Bangalore – 560 034, India
