company application form (1)

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MSPL LTDAffix passport size photographBaldota Group of CompaniesBaldota Enclave, Abheraj baldota road,HOSPET-583203.Ph: (08394) - 232003,232004POST APPLIED FOR:____________________________________1.PERSONAL DETAILS:Name (In Block Letters) : ____________________________________________Praveen kumar D.V.Name of Father/Husband : ____________________________________________Vitthal H DhongadekarDate of Birth : ______/_______/_________11121992Sex : MALE / FEMALEmaleMarital Status : Single / Married / Divorced / Widowed.singleNo. of Dependent Children : _____Present Address :Permanent Address :#1642/11/A, 15th crosss/o Vitthal h dhongadekaranjaneya layoutHaladakatta, post:kondliDavangere-577004siddapur(U.K)-581355Phone No :9964997540Phone No :Email id :[email protected] QUALIFICATIONS:(Starting from the last to Xth Standard)QualificationYear of PassingSchool/CollegeUniversity% / ClassXth standard2008P.E.N. high school, siddapur(U.K)76.32%XIIth standard2010M.G.C. college,siddapur(U.K.)67.50%3.TECHNICAL / PROFESSIONAL QUALIFICATION :QualificationYear of PassingSchool/CollegeUniversity% / ClassB.E.(chemical engineering)2014Bapuji institute of engineering and technology DavangereV.T.U. Belgaum65.14%Accademic Awards (If any) : ____________________________________________________________4.WORK EXPERIENCE :(Starting from the present job) Pls attach extra sheet if requiredName and Address of EmployerPeriod of ServiceJob TitleSalary DrawnReasons for leavingFromTo5.Languages KnownLanguageReadWriteSpeakEnglishyesyesyesKannadayesyesyesHindiyesyesyesMother Tongue:__________________________________________________Marathi6.BRIEF ORG CHART (indicating reporting relationship, peer levels and reportees to the position)7.EXPECTED SALARY2.5-3.0 lacks p.a.8.MEMBERSHIP OF ANY PROFESSIONAL BODY :No 1(If Yes what is the office held)_________________________________________________________________________________________9.PROFICIENCY IN SPORTS & OTHER EXTRA CURRICULAR ACTIVITIES :Volly ballHigh jumpkho kho_________________________________________________________________________________________Hobbiesswimmingbody buildingphotograghyStrengthsPositive attitudehonestconfidentWeakness1)___________________2)___________________3)___________________Did you apply to us previsouly : Yes/No If Yes, what post, If appointed give the date of leaving & Reasons noAre you know or related to If Yes give detailsany employees of this company : Yes / No noAre you member of Employee If Yes give Account No. Provident Fund : Yes / No no10.REFERENCE (Two reference compulsory)NameOccupationContact Details ( email id & Mobile No)Acquaintance PeriodAre You Phisically Handicap : Yes/No If Yes, give breif details noHave you ever suffered from If Yes give brief details noany contagious disease : Yes / NoHave you ever been Prosecuted : Yes / No If Yes, for what offence no11.DECLARATION :I hereby declare that the above said information is true to my knowledge. If any information is found wrong.I shall be liable to dismissed from the service.Date : _____________7/8/14___________________________________Signature of the Applicant______________________________________________________________________________________For Office use onlyAPPOINTED / NOT APPOINTEDDepartmentSignature of DirectorSALARY W.E.FDesignation

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