Employment Application Form Remedy

Ferozguda, Balanagar, Hyderabad -500011 ,Hyderabad- 500 011 . Ph:23777770 Hospitals

Road No4 ,KPHB Colony , Kukatpally , Hyderabad - 500 072. Ph:23158787 e:inforemedy@gmail.com

CANDIDATE (All information to be filled in by candidate's own handwrighting in CAPITAL LETTERS Only )

Name Mr/Ms

Please affix latest

colour photograph
Permanent Address :

CURRENT Mailing Address:

Telephone :Office:_______________________________ Res:________________________

(City code)-(Area Code)-Number (City code)-(Area Code)-Number

Email: Mobile:

Date of Birth Marital Status

DD MM YYY [Plese ( √ )
Single Married

FAMILY BACKGROUND
Parent's /Spouse's Name………………………………………………………………………………………………………………….
Qualifacations……………………………………………………………………………………………………………………………….
Occupation…………………………………………………………………………………………………………………………………..
Designation……………………………………………………Organization………………………………………………………………
Adress………………………………………………………………………………………………………………………………………..
…………………………………………………………………………………………………………………………………………………
Telephone:Off:……………………………..Res:……………………………….Mobile…………………………………………………..
ACADEMIC QUALICATION

Description Schoo/College/university year of passing Medium Marks(%)

Instruction
School
Junior College

Gradution
Post Graduation
Professional Qualification
Other Qualification

References
Plese give two references , who are familiar with your work and their mailing address and
residential phones
Name………………………………………………………………….
Address……………………………………………………………….
…………………………………………………………………………
………………………………………………………………………….
Phone: Office…………………..Phone Res:……………………….
Mobili:………………………………………………………………….

Name………………………………………………………………….
Address……………………………………………………………….
…………………………………………………………………………
………………………………………………………………………….
Phone: Office…………………..Phone Res:……………………….
Mobili:………………………………………………………………….

WHY DO YOU WORK FOR REMEDY ? FOCUS ON YOUR POTENTIAL TO MAKE SIGNIFI CONTRIBUTION.
(Please think carefully and write)

Expected Emoluments

DECLARATION
I certify that the information presented in this Employment Application From and other application material is accurate , complete and
honestly presented I understand and agree that any inaccurate information , misleding information or omission will be cause for the
recision of any offer of employment or for disciplinary action or dismissal if discovered at
a later date , I agree to abide by Remedy Code of Ethics in letter and spirit.

I agree to abide by the Rules and Regulations covering the employment with Remedy I clearly understand that the jurisdiction for all
disputes is Hyderabad ,India

Signature of the Applicant

Place:
Date:

FOR OFFICE USE ONLY

Selected c Waitlisted c Rejected c