EMPLOYMENT APPLICATION FORM
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PLEASE COMPLETE ALL THE SECTIONS OF THIS EMPLOYMENT APPLICATION FORM IN FULL,
AND ATTACH PHOTOCOPIES OF ALL RELEVANT CREDENTIALS.
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YOUR INTEREST IN OUR COMPANY IS APPRECIATED, AND WE LOOK FORWARD TO EXPLORING EMPLOYMENT
OPPORTUNITIES WITH YOU IN DUE COURSE. ACCORDINGLY, A CLEAR UNDERSTANDING OF YOUR EXPERIENCE AND
BACKGROUND WILL NOTABLY ASSIST IN THE MOST APPROPRIATE PLACEMENT FOR OUR MUTUAL BENEFIT.
WE SHALL DEAL WITH THE PERSONAL DATA REFLECTED HERE BELOW IN A PRIVATE MATTER. THIS APPLICATION WILL REMAIN ACTIVE IN OUR
RECRUITMENT DATABANK UNLESS A REQUEST FOR ITS ERASURE IS RECEIVED EARLIER FROM YOUR END, SHOULD YOUR EMPLOYMENT NOT
MATERIALIZE.
POSITION APPLYING FOR (First Choice) SECOND CHOICE
Safety officer
FIRST NAME MIDDLE NAME FAMILY NAME
Dilip Kumar Gaur
BIRTH DATE BIRTH PLACE (City & Country) NATIONALITY AT BIRTH OTHER NATIONALITIES
Day Month year
06-07-2025
GENDER FATHER'S NAME MOTHER'S MAIDEN NAME (In Full)
( ) Male ( ) Female
MARITAL STATUS IF MARRIED, FULL NAME Of SPOUSE
( ) Single ( ) Separated ( ) Widowed
( ) Married ( ) Divorced
NUMBER OF CHILDREN UNDER 22 YEARS OLD (Indicate Ages)
PERMANENT ADDRESS CURRENT CONTACT ADDRESS (If Different from Permanent Address)
Landline: Mobile: Email:
LIST ANY RELATIVES WORKING FOR THIS COMPANY
NAME RELATIONSHIP OCCUPATION LOCATION
Have you ever been arrested or convicted of a felony? (If yes, please give full details)
If currently employed, when will you be able to join this company? Indicate expected Monthly Gross Salary (Specify currency)
May we contact your present employer without jeopardizing your position? Will you accept employment In any country? (If Not, Specify Exclusions)
INDICATE "Fluent", "Average", or "Poor"
LANGUAGE TYPING AND SHORTHAND SKILLS
KNOWLEDGE (Indicate Speed In Words per Minute)
READ WRITE SPEAK
ENGLISH ARABIC OTHER
TYPING
SHORTHAND
COMPUTER LITERACY
Proficient Software Knowledge (Tick Applicable)
( ) Microsoft Windows ( ) Word for Windows ( ) OrgPius for Windows ( ) FoxPro for Windows
( ) Lotus 123 for ( ) Excel for Windows ( ) Auto Cad ( ) lnterGraph
( ) Harvard Graphics ( ) PowerPoint for Windows ( ) Planning & Scheduling (Specify)
( ) Others (Please Specify Below)
(1)
(2)
(3)
(4)
(5)
ACADEMIC RECORD
SCHOOL/COLLEGE/ DATE CERTIFICATE OR LEVEL
COUNTRY MAJOR
INSTITUTE/UNIVERSITY FROM TO COMPLETED
LIST APPLICABLE PROFESSIONAL COURSES TAKEN IN ADDITION TO THE ACADEMIC RECORD
LIST MEMBERSHIPS IN TECHNICAL ASSOCIATIONS AND PROFESSIONAL SOCIETIES
LIST VALID PROFESSIONAL LICENSES AND REGISTRATIONS
NOTE: In the space provided below, please provide a detailed outline for each employment period, specifying duties
and responsibilities, equipment used, and number of employees you supervised (If applicable).
EMPLOYMENT RECORD
PRESENT EMPLOYER (Or most recent if not currently employed)
Employer's Name and Address Business Type
Position Held Number of Employees Supervised
From To Reason for Leaving
Basic Salary Per Month Additional Bonuses, Allowances and Fringe Benefits
(State Currency)
Provide Full Description of Duties, Responsibilities, etc.
PREVIOUS EMPLOYER
Employer's Name and Address Business Type
Position Held Number of Employees Supervised
From To Reason for Leaving
Basic Salary Per Month Additional Bonuses, Allowances and Fringe Benefits
(State Currency)
Provide Full Description of Duties, Responsibilities, etc.
PREVIOUS EMPLOYER
Employer's Name and Address Business Type
Position Held Number of Employees Supervised
From To Reason for Leaving
Basic Salary Per Month Additional Bonuses, Allowances and Fringe Benefits
(State Currency)
Provide Full Description of Duties, Responsibilities, etc.
PREVIOUS EMPLOYER
Employer's Name and Address Business Type
Position Held Number of Employees Supervised
From To Reason for Leaving
Basic Salary Per Month Additional Bonuses, Allowances and Fringe Benefits
(State Currency)
Provide Full Description of Duties, Responsibilities, etc.
ADDITIONAL INFORMATION SHOULD BE PROVIDED ON A SEPARATE SHEET
APPLICANT'S CERTIFICATION AND AGREEMENT
I hereby certify that all answers given and statements made on this Employment Application Form are true and correct. I fully understand that any falsification
or omission made on this Employment Application Form, or any other relevant document, will render me liable to dismissal without notice, and consequently,
I hereby waive all my rights for recourse.
By signing below, you are consenting to our Company using your personal information internally or with external sources should it be required for facilitating
personal or business related functions. These actions include but are not limited to:
Business travel arrangements
Prequalification purposes and project award requirements
Furthermore, I hereby authorize all my previous employers and references to furnish any information related to my employment record.
APPLICANT'S SIGNATURE DATE
