Shakti IT Services (P)

LTD

New Employee
Joining FORM
(Please fill in your
own handwriting)

POST APPLIED
FOR

PERSONAL DATA
First Name: Mr. /Ms. /Mrs. /Dr. /Dr. Ms.________________ Middle Name: _____________ Surname: __________
By what name would you like to be called __________________________________
Fathers/Husbands Name: ______________________________________________
Permanent Address with pin code & landline no.: ___________________________________________________
____________________________________________________________________

Please affix your

Photograph here
Present Address with pin code (If different from above) & land-line no.: _________________________________
____________________________________________________________________
___________________________________________________________________
___________________________________________________________________
Mobile: ______________________ Email: ________________________________
Date of Birth

Place of Birth

Marital Status: Single

Divorced

Nationality

Blood Group

Religion

Married
Widowed

Married since (date): ______________ No. of Children: _______________ No. of dependants___________

EDUCATION (SSC / HSC Onwards)
Degree / Diploma
Certificate /
Course Name

From

To

Institute /

Location

University

Branch of

Total %

Class

Study

Marks

Obtained

Mention any special merits or failures in your education career:

_______________________________________________________________________________________________
Any particular reason for failures:
_______________________________________________________________________________________________

PROFESSIONAL TRAINING
Course

From

To

Institute / Organisation

Details of Training

EMPLOYMENT HISTORY
Present/Last Employment
From________ to ____________ Designation _______________________________ Role _____________________
Name & Address of the Employer:
______________________________________________________________________________________________
Responsibilities in brief ______________________________________________

Reporting Structure

__________________________________________________________________
__________________________________________________________________
Significant Contribution on the Job__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
Current / last salary and Perquisites (Please give the exact break-up)
Monthly Payment

Basic

HRA

Conv.

Annual Payments

LTA

Exgratia

Perquisites

House

Car

Retirement Benefits

PF

Gratuity

Total

Medical

SA

Total
Details of Loans availed __________________________________________________________________________
Reason for Leaving ______________________________________________________________________________
Are you covered by any Service Agreement?

Yes

No

If Yes, give details: _____________________________________________________________________________

Previous Employment
Duration
From

To

Yrs/Mths

Employers
Name &
Address

EXTRA CURRICULAR ACTIVITIES

Industry

Designation

Role &
Nature of
work

LANGUAGE

Reasons for
leaving

Mention any two interest and proficiency achieved in them

_____________________________________________________

Give your mother tongue first

Language

Are/were you personally connected with any type of business at

present /past

Yes

Under
Stand

Speak

Read

Write

No

If Yes, give details: _____________________________________

Have you ever been convicted by any Court of Law? - Yes / No
If Yes, Please mention nature of offence and resultant conviction:
______________________________________________________

Family Details
Name

Occupation & Address

Mobile No.

Father:

Mother:
Spouse:
Sibling
1:

Sibling
2:

Others:

References
Name

2 Personal (other than family members) and 2 Professional

Occupation & Address (Home / Office)

Mobile No.

1.
2.
3.
4.

Any additional information that you may like to give

_______________________________________________________________________________________

_______________________________________________________________________________________
Your career goals: _______________________________________________________________________________

_______________________________________________________________________________________
Would you like to be considered for employment in any other position in Shakti IT? Give details

_______________________________________________________________________________________
Expected Salary ___________________________ Can join by (date) ______________________________________
I agree that my employment is subject to the verification of the statements made by me in this form.
Signature _____________________________________

Date _________________________________________

FOR Shakti IT Services USE ONLY

ASSESMENT BY SELECTION TEAM
Date of Interview: _____________________ Selection Team: ___________________________________________

DECISION OF SELECTION TEAM

Select

Reject

Put on Hold

Consider for

Brief reason for the decision: _____________________________________________________________________

_____________________________________________________________________________________________
If selected, offer details:
Designation

Grade

SBU / Dept.

Salary Offer

Ref. Requisition No. ___________________________ dated _______________ of SBU / Dept.

Any other commitments or conditions made: _________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________

______ __________________________________
Date

Signature of the selection team member/s

Medical Report: Fit

Unfit