employment application

PERSONAL (PLEASE USE UPPER CASE LETTERS)

NAME (LAST) ADDRESS FOR COMMUNICATION (FIRST) (MIDDLE) PHONE (RES) PHONE (OFF) E-MAIL PHONE

PERMANENT ADDRESS THROUGH WHICH YOU MAY BE REACHED

DATE OF BIRTH MM YYYY DD HOW WERE YOU REFERRED TO HUGHES

MARRIED MALE

SINGLE FEMALE

NATIONALITY BLOOD GROUP EMERGENCY CONTACT PHONE NO.

HAVE YOU PREVIOUSLY WORKED FOR HUGHES? YES NO WHEN EMP # RELATIVES EMPLOYED BY HUGHES (STATE NAME, RELATIONSHIP AND COMPANY LOCATION. IF NONE, STATE NONE)

EDUCATION
SCHOOL/COLLEGE/UNIVE RSITY (NAME & LOCATION) DATE (MONTH/YEAR) --------------------FROM TO DEGREE/DISCIPLINE DATE RECEIVED MAJOR SUBJECTED MARK OBTAINED (PERCENTAGE / GPA POSITION)

HIGH SCHOOL 10 + 2 GRADUATION POST GRADUATION PH. D. OTHER EDUCATION / SPEICAL TRAINING

PERSONAL QUALIFICATIONS AND ACHIEVEMENTS

PROFESSIONAL AFFILIATIONS

HONOURS, AWARDS AND SCHOLARSHIPS

PUBLICATIONS / THESIS / PATENTS

LANGUAGES (INDIATE PROFICIENCY TO SPEAK, READ OR WRITE, UNDERLINE MOTHER TONGUE)

GENERAL
WHAT TYPE OF WORK ARE YOU SEEKING?

HAVE YOU APPLIED TO HSS FOR EMPLOYMENT PREVIOUSLY? (IF YES, GIVE DETAILS).

ARE YOU WILLING TO SERVE IN ANY CITY (INDIA / ABROAD)? IF NOT STATE PREFERENCES.

WHEN CAN YOU JOIN IF SELECTED?

DO YOU HAVE A VALID PASSPORT? IF YES GIVE NUMBER AND VALIDITY.

WORK EXPERIENCE (STARTING WITH FIRST JOB UPTO YOUR CURRENT JOB)
FROM PERIOD TO EMPLOYERS NAME, ADDRESS & NATURE OF BUSINESS

TOTAL SALARY INCLUDING ALL BENEFITS PER YEAR DESIGNATION & BRIEF JOB DESCRIPTION / RESPONSIBILITIES STARTING: LEAVING: NAME OF SUPERVISOR: REASONS FOR LEAVING

EMPLOYERS NAME, ADDRESS & NATURE OF BUSINESS FROM TO

TOTAL SALARY INCLUDING ALL BENEFITS PER YEAR DESIGNATION & BRIEF JOB DESCRIPTION / RESPONSIBILITIES STARTING: LEAVING: NAME OF SUPERVISOR: REASONS FOR LEAVING

EMPLOYERS NAME, ADDRESS & NATURE OF BUSINESS FROM TO

TOTAL SALARY INCLUDING ALL BENEFITS PER YEAR DESIGNATION & BRIEF JOB DESCRIPTION / RESPONSIBILITIES STARTING: LEAVING: NAME OF SUPERVISOR: REASONS FOR LEAVING

EMPLOYERS NAME, ADDRESS & NATURE OF BUSINESS FROM TO

TOTAL SALARY INCLUDING ALL BENEFITS PER YEAR DESIGNATION & BRIEF JOB DESCRIPTION / RESPONSIBILITIES STARTING: LEAVING: NAME OF SUPERVISOR: REASONS FOR LEAVING

CURRENT JOB
DATE OF JOINING (MONTH & YEAR) EMPLOYERS NAME, ADDRESS & NATURE OF BUSINESS

EMPLOYERS ANNUAL TURNOVER TOTAL NO. OF EMPLOYEES BRIEF JOB DESCRIPTION / RESPONSIBILITY

INITIAL POSITION

TO WHOM ARE YOU RESPONSIBLE?

CURRENT POSITION WHO IS RESPONSIBLE TO YOU?

REMUNERATION (PER ANNUM) AT THE TIME OF JOINING AT PRESENT

SALARY

CASH ALLOWANCES

TOTAL

TOTAL COST TO THE COMPANY (CTC)

AT THE TIME OF JOINING

LAST YEAR

CURRENT YEAR

CTC BREAKUP BASIC SALARY PER YEAR OTHER COMPONENTS PER YEAR PROVIDENT FUND PER YEAR GRATUITY PER YEAR SUPERANNUATION PER YEAR TOTAL PER YEAR BENIFITS WHOSE VALUE IS NOT INCLUDED IN CTC

ESOP (IF ANY, GIVE DETAILS)

USE THIS SPACE FOR COMMENTS ABOUT YOUR SPECIAL ABILITIES, SPECIAL WORK WHICH YOU HAVE DONE OR WORK YOU WOULD LIKE TO DO

REFERENCES
NAME FIVE PERSONS PREFERABLY FORMER SUPERVISORS OR PROFESSORS FAMILIAR WITH YOUR QUALIFICATIONS, WHOM WE HAVE YOUR PERMISION TO CONTACT NAME. HOME ADDRESS & PHONE NUMBER OFFICE PHONE NUMBER RELATIONSHIP EX COLLEAGUE FACULTY FRIENDS SUPERVISOR RELATIVES OTHER EX COLLEAGUE FACULTY FRIENDS SUPERVISOR RELATIVES OTHER EX COLLEAGUE FACULTY FRIENDS SUPERVISOR RELATIVES OTHER EX COLLEAGUE FACULTY FRIENDS SUPERVISOR RELATIVES OTHER EX COLLEAGUE FACULTY FRIENDS SUPERVISOR RELATIVES OTHER

SECURITY
PLEASE ANSWER ALL QUESTIONS USING YES OR NO. ALL QUESTIONS MUST BE ANSWERED. 1. HAVE YOU EVER BEEN CONVICTED BY A COURT OF LAW OR ANY OTHER JUDICIAL BODY? (IF YES, DETAILS) YES NO

2. WERE YOU EVER SERIOUSLY ILL, INJURED OR OPERATED, WHICH MAY MAKE YOU UNFIT FOR EMPLOYMENT AT HSS? (IF YES, DETAILS)

YES

NO

3. DO YOU HAVE ANY MENTAL OR PHYSICAL DEFECTS? (IF YES, DETAILS)

YES

NO

4. ARE YOU UNDER ANY OBLIGATIONS OF ANY OF YOUR PREVIOUS EMPLOYERS OR OTHERS THAT MAY MAKE YOU UNFIT FOR EMPLOMENT AT HSS? (IF YES, DETAILS)

YES

NO

FALSE STATEMENTS OR MISREPRESENTATIONS WILL DISQUALIFY YOU FROM CONSIDERATION. IF YOU HAVE ANY QUESTIONS CONCERNING THIS FORM OR THE SECURITY PORTION, PLEASE ASK TO SEE A HUMAN RESOURCES PERSON OR HSS.

FAMILY BACKGROUND (NAME, DATE OF BIRTH, OCUPATION OF FAMILY MEMBERS INCLUDING SPOUSE, CHILDREN, PARENTS, BROTHERS, SISTERS)

DEPENDENT? (YES / NO)

ANY OTHER INFORMATION YOU MAY WISH TO PROVIDE

PRE-EMPLOYMENT STATEMENT I AUTHORIZE HUGHES TO OBTAIN INFORMATION REGARDING MY EMPLOYMENT AND EDUCATIONAL RECORDS FROM FORMER EMPLOYERS, SCHOOL AND COLLEGE OFFICIALS AND PERSONS NAMED HEREIN AS REFERNECES, AND I RELEASE ALL CONCERNED FROM ANY LIABILITY IN CONNECTION THEREWITH. IF EMPLOYED BY THE COMPANY, I UNDERSTAND THAT SUCH EMPLOYMENT IS SUBJECT TO THE POLICIES AND REGULATIONS OF THE COMPANY. I FURTHER UNDERSTAND THAT ANY FALSE STATEEMNTS OR MISREPRESENTATIONS MADE BY ME ON THIS APPLICATION OR ANY SUPPLEMENT THERETO WILL BE SUFFICIENT GROUNDS FOR IMMEIDATE TERMINATION. I UNDERSTAND THAT MY EMPLOYMENT AT HUGHES SHALL BE CONDITIONED UPON SATIFACTORY COMPLETION OF A PRE-EMPLOYMENT MEDICAL ASSESSMENT. FURTHER, I UNDERSTAND THAT SHOULD I BE EMPLOYED BY HUGHES, MY CONTINUED EMPLOYMENT SHALL BE CONDITIONED UPON THE SUCCESSFUL COMPLETION OR MEDICAL TESTS UPON THE REQUEST OF THE COMPANY. I UNDERSTAND THAT IF I AM EMPLOYED BY THE COMPANY, MY EMPLOYMENT WILL NOT BE FOR ANY SPECIFIED TERM AND MAY BE TERMINATED BY ME OR BY THE COMPANY AT ANY TIME FOR ANY REASON.

DATE

HUGHES SOFTWARE SYSTEMS Plot #31, Electronic City, Sector 18 Gurgaon 122015, INDIA Tel: +91-124-6346666 / 6455555 Fax: +91-124-6342810 or 811 Fax: +91-11-6479305 or 9306