APPLICATION FORM [ for contract employees ]

Instructions : 1. Fill in the form in your own handwriting

2. Incomplete form will not be considered
Please Affix Your
Latest
FULL NAME IN BLOCK LETTERS : Photograph Here
FIRST NAME MIDDLE NAME SURNAME

How do you prefer your name to be stated in written communication?

Present Mailing Address :

Contact Phone No. [ If Any ] : STD Code :

Permanent Address :

Contact Phone No. [ If Any ] : STD Code :

LANGUAGES [ Please underline your Mother Tongue ] :

Speak
Read
Write
Nationality Domicile State Period of Stay in
Present State

Date of Birth / Age (Years) Religion Marital No of Children

Status
Height Weight (KG) Physical Disability [ If Any ] Eye Sight [ If wearing
(CMS) Glasses or Contact Lenses ]

Major Illness / Operation So Far

DETAILS OF YOUR IMMEDIATE FAMILY MEMBERS :

Name Relationship Age Occupation Organisation &
Position

L & T Infotech – Internal Use

EDUCATION :
Examination Passed Name of School, College or Month & Year of Marks (%)
University Passing

Please explain if there is a gap of more than six months in academic year :

Please indicate subjects not cleared in the first attempt – Semester wise / Year wise

SPORTS AND GAMES – PARTICIPATION

Sr. Name of Sport / Represented School / Position Held Duration
No. Game College / Others From To

Details of Previous Employment [ Name of the employer, Designation, Job, Salary,

Total Experience etc. ]

Who referred you to us :

Special Interests and Hobbies :

Mention your main strengths :

I declare that the information given above is true to the best of my knowledge and I
understand that any false information, misrepresentation or omission of facts called
for in this application, or other company records may result in my immediate
dismissal without notice even if subsequently employed.

I authorise inquiry with regard to my character, ability or habits to any and all
persons and agree to hold such persons harmless with respect to any information they
may give.

Date :
Place :
Signature of
Applicant
L & T Infotech – Interanl Use 1st July 2007