EMPLOYMENT

APPLICATION Date: ____ / ___ / ______

FORM

Post Applied For

Paste
Recent
Personal Passport Size
Information (To be filled by applicant clearly and completely) Photograph

PERSONAL DETAILS

Name Date of Birth

Email ID Contact No.

Sex Male / Female Birthplace & State

Marital Status Single / Married / Divorcee Date of Marriage

Caste General / SC / ST / OBC Religion

Identification Mark/s Blood Group

Aadhaar No. PAN No.

If Yes then
Are you Person with
Yes / No Percentage of
Disability?
Disability

If Yes then Category of

Locomotor Disability / Dwarfism / Blindness / Hearing Impairment
Disability

English (___) / Hindi (___) / Any other (Please specify: ________________ )

Known Languages
Mother Tongue: _________________________

ADDRESS DETAILS
Address Type Particulars Pincode
Present

Permanent

EMERGENCY DETAILS
Name & Relationship Contact No.

Address Email Id

FAMILY DETAILS (Parents / Guardians / Spouse / Children)

DOB Dependent
Name Relationship Age Occupation
(dd-mm-yyyy) (Y / N)
 ACADEMIC QUALIFICATIONS

Part Time/ % of
Name of Course Duration
Examination / Full Time/ Marks /
Course Name Institution / Correspon
Out of Specialization
Start Date End Date GPA
University dence
(dd-mm- (dd-mm- Obtained
yyyy) yyyy)

Post
Graduation

Graduation

Diploma

HSC (12th)

SSC (10th)

PROFESSIONAL QUALIFICATIONS
Course Duration
Part Time/ % of
Examinatio Name of
Start End Full Time/ Marks / Special-
n / Course Institution / Out of
Date Date Correspon GPA ization
Name University
(dd-mm- (dd-mm- dence Obtained
yyyy) yyyy)

TRAINING / CERTIFICATES (if any)

Name of Year of Passing
Course / Stipend
Field Institution /
Certification (if any) End
Organization Start Date
Date
Total Experience Years

DETAILS OF WORK EXPERIENCE

Current Employment
Working Period
Current
Name of the Organization Designation From To Function CTC
(dd/mm/y (dd/mm/ (P.A)
yyy) yyyy)

Name :

Designation:
Supervisor's Details:
Contact No.:

Email ID :

Permanent :
No. of Direct Reportees
Contractual :

Past Work Experiences

Working Period
From To CTC
Organization Designation Function
(dd/mm/y (dd/mm/ (P.A)
yyy) yyyy)

Please give reasons for breaks in Career History (if any)

From To Reason
Months

Reason for
leaving

Reason for
leaving
 Remuneration Structure (You may need to support this with a salary certificate)
PARTICULARS PRESENT
Basic Salary
Dearness Allowance
House Rent Allowance
MONTHLY EMOLUMENTS

Children Education Allowance

Children Hostel Allowance
Medical Reimbursement
Transport / Conveyance Allowance
Fuel & Maintenance
Any Other (If Specify)
i.
ii.
iii.
SUB TOTAL (A)

Bonus
Incentive
Leave Travel Assistance
ANNUAL BENEFITS

Canteen / Lunch Expenses

Gift Coupons
Food Coupons
Any Other (If Specify)
i.
ii.
iii.
SUB TOTAL (B)

Provident Fund
RETIREMENT
BENEFIT

Gratuity

Superannuation Fund
SUB TOTAL (C)

Hospitalization Insurance
BENEFITS
MEDICAL

Medical Reimbursements (Maximum Limits)

Group Life / Accident Insurance

SUB TOTAL (D)

TOTAL SALARY

Leave - Casual / Sick / Privilege

LEAVE

Leave - Any other (specify)

Leave - Accumulation / Encashment
 REFERENCES:
(Professional acquaintances only, whom we can contact for verification)

Name Nature of Association Email id Contact No.

PRIOR ASSOCIATION:
(Have you ever applied or have been interviewed for a job in this company)

YES / NO

If Yes, please give details:

Position : Department:
Person who conducted the
Interview:

I certify that the information given above is true and correct. I understand that my
appointment may be cancelled without notice in case any of the above information is
found incorrect.

I hereby authorize BSES Rajdhani Power Ltd. and its representative to verify
information provided by me in my resume and application of employment and to
conduct enquiries as may be necessary.

Date Signature of Candidate

 BYPL/2016/Version 1.2

Given below is the Authorization letter, where candidate needs to sign to authorize for his/her background
verification. Candidate has right to deny and not sign the Authorization letter if he/she does not want to
allow for verification.
AUTHORIZATION NOTE
‘To whom so ever it may concern’
I ___________________, authorize the Company or the retained third parties to obtain investigative
employment verification report in connection to my application for employment .

The employment verification report may include information regarding my character, general reputation,
personal characteristics, Education (Authentication of acquired or pursuing Degrees/Diplomas); Employment
history; Credit history; court records, including criminal verification records as permitted by law; Passport
Verification; Permanent Account Number verification; Drug Test; Finger Print Verification; Address
Verification ,references from professional and personal associates as maybe applicable and any other check
as found relevant for the profile.

I __________________, further understand and agree that the employment verification report may be
obtained at any time and any number of times as necessary before, during or post my employment.

I provide my consent to the company or the third parties for the processing of any sensitive personal
information obtained for the purpose of verification.
I understand that some or all of the information I have provided in this application form will be held as
digitized or physical records for a period as defined by the data retention norms.
I hereby authorize all previous employers, educational institutions, consumer reporting agencies and other
persons or entities having information about me to provide such information to the Company or any other
third party/ies retained by them for the purpose.

I understand that the continuance of the employment or the offer of employment is contingent upon the
outcome of the background check conducted on me.
The proof of Identity enclosed and self attested for reference. A Photostat, or any other copy, of this
instrument bearing my signature shall be equally legally valid as the original.
All the information furnished by me in the Background Verification Form is true to the best of my knowledge.

Name :
Designation:
HR Details:
Contact No. :
Email ID :

Signature: ________________

Name: ___________________

Date: ____________________

Place: ____________________

Note: It is mandatory to duly sign the form on the space provided above or else the application form
would be rejected.
 BYPL/2016/Version 1.2

uthorize for his/her background

tter if he/she does not want to

s to obtain investigative
ent .

haracter, general reputation,

egrees/Diplomas); Employment
s permitted by law; Passport
Verification; Address
applicable and any other check

verification report may be

post my employment.

f any sensitive personal

cation form will be held as

ms.
r reporting agencies and other
to the Company or any other

ment is contingent upon the

r any other copy, of this

ue to the best of my knowledge.

ve or else the application form