The Sirpur Paper Mills Ltd.

SIRPUR KAGHAZNAGAR 504 296 (A.P)

Dist. Adilabad
Cable: SIRPAPER
Phone: (08738) 23344, 238045 (PBX)

Fax
email

: (08738) 238642
: mis@sirpurpaper.com

APPLICATION FOR EMPLOYMENT

PART I
1. Post applied for ______________________________________
2. Full Name __________________________________________
3. Fathers/
Husbands Name______________________________________

AFFIX PASSPORT
SIZE PHOTO

4. Nationality_________________ Whether SC/ST ___________

(a) Religion ______________ (b) Caste ________________
5. Full Address (a) Present _____________________________________________________________

(b) Permanent __________________________________________________________

___________________________________________________________________________________
Contract phone No/Mobile _________________ (d) e-mail ID _________________
6. Date of Birth___________________________ 7. Age _________________ Years
8. Place of Birth __________________________ 9. Marital Status __________________________
10. Height ___________________ CM

11. Weight ________________________ Kgs.

12. Give details of your children and dependents in column below:

Sl. Name
Sex
Age Relationship
N
o.
1
2
3
4
5
6
13. Have you/yours wife undergone Family Planning Operation ?

Present occupation if
any

Yes/No.

14. Do you have any physical disability? If yes, give details___________________________________

___________________________________________________________________________________
___________________________________________________________________________________

15. Academic/Professional/Technical Qualifications (In chronological sequence beginning from school

Leaving Examination)
Examination
passed

Year of
passing

Name of the
School/College/
Institution

Name of the
University/
Board

% of
Marks

Major
Subjects
studied

16. Distinction, honours and awards (Academic, extra Curricular, community etc.)
Sl.No.

Distinction/Award

Given by

Year

Basis of selection

Duration

Year

17. Please list the training and development programmes attended.

Sl.No.

Course/Training
Programme

Conducted by

18. Member ship of professional societies/institutes

Name of
Society/Institution

Sl.No.

Status

Membership No..If any

.
19. Languages Known:
Speak
Language

Fair

Good

Read
Fluent

Fair

Good Fluent

Write
Fair

Good Fluent

Examination
passed (if any)

20. Have you undergone any Apprentices Training : YES/NO

If Yes :
Organization in which
Apprenticeship done

Duration

Paid or Unpaid

PART II
21. Record of Experience (from the date of leaving education upto date)
Name & Full
address of the
Employer &
Period
nature of
Industry/Business
/Annual
Sales/Employ
ment
From
To

a) Present:

b). Last:

c). 2nd Last:

d) 3rd Last:

Position held

At Start

At End

Length
of
service
Yrs/Mo
nths

Major
Respons
ibilities

Gross
Remuneration
Reason
for
leaving
Starting

Final

PART III
22. Please outline your present job responsibilities and attach the existing organization chart showing
your relationship with superiors Peers & Subordinates.

22. Are you related to any of the Directors or any employee working in the company/member units of
our organization ? If yes, give details:
Name of the relative

Name of the Unit

Department

Relationship

24. Give three personal references (other than relatives)

Sl.No

Name and address

Telephone No.

Position

How long known

1
2
3
25. Family background give brief information regarding Father, Mother, Brothers & Sisters including
their occupation (special mention should be made of the applicants financial dependence on dependence
on family if any)

26 Hobbies: extra curricular / leisure activates, social work etc.

27. Are you a member of (If yes, give details there of including membership No.)
(a). Provident Fund _____________________________________________________________
(b). Family Pension Fund Scheme _________________________________________________
. ESI Scheme ________________________________________________________________
(d). Superannuation Scheme ______________________________________________________
(e). Employment Exchange Reg.No.____________________ District ____________________
28. Have your ever been convicted : If yes, please give details:

29. Name & Address of next of kin _______________________________________________________

(who should be contacted in case of emergency) __________________________________________
__________________________________________________________ Telephone No.______________
30. Describe your significant achievements and your evaluation as to why you consider yourself suitable
for this post.
____________________________________________________________________________________
___________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
31. Present Employer & Address:
Salary Particulars:
Sl.No. Details of Emoluments
01.

Salary : Basic

02.

D.A.

03.

V.D.A

04.

H.R.A.

05.

LTA/LTC

06.

ESI/Medical Reimbursement

07.

Conveyance Allowance

08.

Education Allowance

Per Month [R.s]

Expected salary per month

09.

Soft. Furnishing

10.

Production Bonus

11.

Any other Allowance

Sub Total (i)

12.

P.F. Contribution

13.

Superannuation

14.

Gratuity

15.

Annual Bonus / Exgratia

16.

Any other benefit

Sub Total (ii)
Grand Total (i) + (ii)

17.

HRA / Accommodation

32. Expected Gross Salary ______________________________________________________

33. How much time would you require to join, if selected ____________________________________
I hereby declare that the information furnished above are True and Correct to best of my knowledge.
Place:
Date:

Remarks the Interview Committee:

Date:

Applicants Signature.