Bosch Limited.

PostBox Number 3000, Bangalore – 560 030 Phone 22992111/2222088

Grams: MICODIESEL FAX:22272728

APPLICATION FOR EMPLOYMENT Reference Number:      

MANAGEMENT STAFF
1. Answer each column fully
POSITION APPLIED FOR TOTAL INDUSTRIAL GROSS SALARY DATE OF APPLICATION IF SELECTED, WHEN CAN YOU
EXPERIENCE EXPECTED (dd/MM/yyyy) JOIN? (dd/MM/yyyy)
GA2009
Years 0 Months 0                  

PERSONAL DATA
NAME IN FULL (Surname First, As In The Certificate)
     

(SPACE FOR RECENT

PHOTOGRAPH TO
SEX DATE OF BIRTH PLACE OF BIRTH BE AFFIXED
MALE (dd/MM/yyyy) DURING THE TIME
      OFINTERVIEW)
PLACE       STATE      

MOTHER TONGUE NATIONALITY MARITAL STATUS RELIGION

            SINGLE      

SPOUSE’S NAME OCCUPATION

- -
DO YOU BELONG TO SC/ST NO
FATHER’S NAME OCCUPATION
           

DEPENDENT CHILDREN NO./GENDER NO. OF DEPENDENTS(OTHER THAN SPOUSE AND CHILDREN)

NO.1 NO.2 NO.3 PARENTS OTHERS(SPECIFY)
SEX - SEX - SEX -            
BORN (MON-YEAR) BORN (MON-YEAR) BORN (MON-YEAR)
                 
PRESENT ADDRESS PERMANENT ADDRESS
           

           
           
     
      CITY.       PIN.      
CITY.       PIN.       STD CODE.       E-MAIL     
STD CODE.       E-MAIL      
TEL NO.       MOBILE NO.      TEL NO.       MOBILE NO.      
EDUCATION
TYPE OF EDUCATION NAME & LOCATION DEGREE YEAR % OF CLASS/RANK/ MAJOR SUBJECTS
OF INSTITUTION ATTENDED MARK
S
FROM:          
SSLC                   PASS
TO:    
     
HSC/PUC             FROM:    
      PASS
TO:    

      FROM:    
COLLEGE/GRADUATION            
TO:          

FROM:    
PROFESSIONAL 1            
           
TO:    

FROM:    
PROFESSIONAL 2                        
TO:    

TRAINING

NAME & LOCATION DURATION

OF FROM TO NATURE OF TRAINING
INSTITUTION (Project, placement, etc.)
MONTH YEAR MONTH YEAR
                                 
EXPERIENCE

NAME & ADDRESS

OF PERIOD EMPLOYED GROSS
EMPLOYER POSITION, TITLE, SALARY
(Begin with current employer TYPE OF WORK & DRAWN
and REASON FOR LEAVING PER
FROM TO
wherever there are gaps MONTH
explain)
MONTH YEAR MONTH YEAR

      01      01      POSITION :            

TITLE :      

TYPE OF WORK :      

REASON FOR LEAVING :      

      01      01      POSITION :            

TITLE :      

TYPE OF WORK :      

REASON FOR LEAVING :      

      01      01      POSITION :            

TITLE :      

TYPE OF WORK :      

REASON FOR LEAVING :      

      01      01      POSITION :            

TITLE :      

TYPE OF WORK :      

REASON FOR LEAVING :      

ARE YOU UNDER ANY BOND TO AN EDUCATIONAL MAY WE COMMUNICATE WITH YOUR PRESENT EMPLOYER? YES
INSTITUTE, PAST OR PRESENT EMPLOYER? No

SPECIFY AMOUNT, IF ANY : Rs. 0

INTERESTS
ACHEIVEMENTS IN SPORTS, LITERARY ACTIVITIES, ETC. :
     
HOBBIES & SPECIAL INTERESTS :
     
MEMBERSHIP OF PROFESSIONAL ASSOCIATIONS :
     
PAPERS PUBLISHED, IF ANY :
     
1. Please provide your current (a) job responsibilities (b) department organisation structure (c) the number and designation of people you supervise
and (d) the person you report to.
(a)

(b)

(c)

(d)
2. What are your career objectives ?
     

3. Any other information you would like to give.

     
Please furnish your present remuneration details. Date of last salary revision :      

Date of next salary revision :      

Compensation Element Amount (Rs) REMARKS

MONTHLY :

Basic Salary 0

Dearness Allowance 0

House Rent Allowance 0

Conveyance Allowance 0      

City Compensatory Allowance 0

Children’s Education Allowance 0

Incentive 0

Other perquisites in cash or kind (Specify details) 0

Sub Total 1 0      

ANNUAL :
(Indicate compensation per annum)

Leave Travel Allowance 0      

Medical 0
Bonus / Ex. Gratia 0

Other perquisites in cash or kind (Specify details) 0

Sub Total 2 0      

RETIRALS :

PF
0      

Gratuity 0

Superannuation 0

Sub Total 3 0      

TOTAL(Annualised)
(Sub Total 1 + Sub Total 3) x 12 + Sub Total 2) 0      

DEDUCTIONS / RECOVERIES, IF ANY

0 0      

DO YOU STAY IN OWN HOUSE

RENTED/LEASED HOUSE RENT PER MONTH 0
ANY OTHER (Please give details)
     
LANGUAGE
LANGUAGE                        
PROFICIENCY

CAN SPEAK
CAN READ
CAN WRITE

HEALTH
HEIGHT (CMS) WEIGHT (KGS) BLOOD GROUP VISION PHYSICAL HANDICAPS, IF ANY
                  R       L            
MOST RECENT ILLNESS FROM TO NATURE OF ILLNESS
no                  

CHRONIC ILLNESSES IF ANY (High blood pressure,diabetes,etc) MAJOR SURGICAL OPERATIONS, IF ANY
           

REFERENCES
FRIENDS / RELATIVES EMPLOYED IN BOSCH(Including ex-employees of Bosch)
NAME DESIGNATION RELATIONSHIP
                 

                 

CHARACTER / EMPLOYMENT REFERENCES (Preferably persons closely associated with your education/work experience; exclude relatives and
Bosch Employees)
NAME PROFESSION / DESIGNATION MAILING ADDRESS
                 

MOBILE.      E-MAIL     
                 

MOBILE.      E-MAIL     

ARE YOU A MEMBER OF ACCOUNT NO.

EMPLOYEES’ PROVIDENT FUND SCHEME (EPF) No      

EMPLOYEES’ FAMILY PENSION SCHEME No      

EMPLOYEES’ STATE INSURANCE SCHEME (ESI) No      

GENERAL
HAVE YOU EVER BEEN CONVICTED FOR A CRIME OR IS THERE A CRIMINAL CASE PENDING AGAINST YOU? No
IF YES PLEASE SPECIFY      

HAVE YOU APPLIED TO BOSCHBEFORE? No

IF YES PLEASE SPECIFY      

INDICATE LOCATIONAL PREFERENCE/CONSTRAINTS, IF ANY

     
CONTACT PERSON IN CASE OF EMERGENCY (Preferable local)

     

NAME       ADDRESS      

RELATIONSHIP      

TEL NO.      

By filling this application, I certify that the statements made by me above are true, complete and correct. I agree that in case the Company finds at
any time, the information given by me in this application form is not correct, true or complete, the Company will have the right to withdraw,
if selected, the Letter of Appointment before I join services or to terminate my appointment at any time without notice or compensation
after I have taken up service.

PLACE : DATE : SIGNATURE :

Please fill up incase application is sent through consultant.

Name of the Consultant:      

E-MAIL ID :      
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