APPLICATION FORM

PLEASE COMPLETE ALL SECTIONS IN BLOCK LETTERS IN YOUR OWN HANDWRITTING

Full Name: _____________________ Middle Name: __________________ Last Name: _____________________
Date of Birth: ____________ Place of Birth: ______________________ Gender: M/ F
(DD/MM/YY)
Fathers Name: ________________________ Email: ____________________________
Marital Status: ______ Blood Group: _____Nationality: ________PAN : _____________
Permanent Address: _____________________________________________________
_______________________________________________________________________

PHOTOGRAPH

Landmark: ______________________________________________________________
Pin: _________________ City: _________________ State: _______________________

Contact No (Residence): __________________ Contact No (Mobile): _______________ Period of Stay (Yrs): _______

Current Address: ________________________________________________________________________________

_______________________________________________________________________________________________
Landmark: ______________________________________________________________________________________
Pin: _____________ City: _____________ State: ________________
Contact No (Residence): __________________ Contact No (Mobile): _______________ Period of Stay (Yrs): ______

Education Qualification Details

Period
Qualification

Professional Experience
Years, Months

Name & City of School/ College

From
(MM/YY)

To
(MM/YY)

Total Experience

Board/
University

Type
( Full Time/
Correspondence)

EMPLOYER(Mention past
two employers)

Period (From-To)
Designation

Major Responsibilities
(MM/YY)

Do you have any police report/legal cases pending against you? Yes/No
If yes, kindly furnish details _________________________________________________________________________
Have you defaulted/ delayed on any Loan payments? Yes/ No
If yes, kindly furnish details __________________________________________________________________________
Do you have any loan of value which is more than 6 months of your present CTC?
If yes, please provide purpose of loan___________________
Have you ever been discharged, dismissed or terminated from any of your employment? Yes/ No
If yes, kindly furnish details __________________________________________________________________________
Are you suffering from any handicaps, ailments or are undergoing long term medication?
If yes, kindly furnish details __________________________________________________________________________
Have you previously been interviewed by us for a position? Yes/ No
If yes, kindly furnish details __________________________________________________________________________
Do you have any relatives working for Edelweiss? Yes/No
Name __________________________________
Relationship ________________________________________
Name __________________________________
Relationship ________________________________________
References
Name

Organization

Current Title

Your Professional
Relationship with
him/her

Mobile No.

1.
2.

I undertake that the information provided by me above are true, complete and correct. I agree and
understand that, in the event that company finds at any time, that any information provided by me are false
or, misrepresented; the company retains the right to immediately withdraw my offer of job or terminate my
job, without notice or compensation.

Place: .......................................
Date: ..............................................

Signature: .................................................