APPLICATION FOR EMPLOYMENT

INSTRUCTIONS:
It is mandatory for you to complete the form in all respects.
The information you provide must be complete and correct and the same shall be treated in strict confidence
The details on this form will be used for all official requirements should you join the organization
 APPLICATION FOR EMPLOYMENT

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Affix photograph

Matix Group
Employee Code Company Name(applied for) Position (applied for)

Department Location Date of Joining

PERSONAL INFORMATION

Salutation: Mr. Ms. Dr. Dr.(Ms) Others.________ The way you write your Name:

Full Name (First, Middle, Last) Former Name / Maiden Name:

Date of Birth (dd/mm/yy) Place of Birth Email Id

Height (in cms) Weight(in Kgs) Blood Group

Nationality Domicile State Religion

PAN Card No. Passport No. Social Security Number (if applicable)

Gender Marital Status : Date of Marriage

Male Single
Married Divorced
Female Widowed
Driving Licence no Catergory: General Schedule Caste Ex Servicemen
OBC Schedule Caste Other

FAMILY PARTICULARS
Family Member Name Date of Birth Education Occupation

Spouse
Children

Father
Mother

Siblings

CONTACT DETAILS
Current Address Period of stay Residence Number
From (mm/yy) To (mm/yy)

Prominent Landmark Mobile number

Permanent Address Period of stay From Residence Number

(mm/yy) To (mm/yy)

Prominent Landmark
 ACADEMIC QUALIFICATION
Please attach copy of Degree and Final year mark sheet.
(Start from the latest qualification. End with SSC)
Institution / Duration of Course Course type Grade
College/ School Fulltime/ CGPA Month &
University
Degree Certificate Name & Address Part time/ Specialisation Marks Year of ID/ Roll No
Board
Corresp Div Passing
From To

Please tick mark the documents submitted for this qualification along with this form
Marksheet Provisional Certificate Degree Certificate None

PAST EMPLOYMENT DETAILS

Total Work Experience: Years ____________ Months ______________

EMPLOYMENT HISTORY
(List most recent first and covering last 2 employers) Current Employer

Note: Ensure that you are descriptive wherever necessary – e.g. If Co. is closed, do mention it. Employee Code/ ID/ Number is mandatory. If your previous
employer did not provide one, please mention and state reasons for the same.
Name of Current Employer Address of Current Employer

Telephone No Employee Code/No Designation Department

Employer’s Annual Sales & No of employees:

Employment Period Manager's Name Manager's Contact No Can a reference be taken now?

From To
Manager's Email ID Yes

No
Duties & Responsibilities Reasons for leaving

First Salary drawn Was this Position Agency Details (if temporary or contractual), provide details
Permanent
Last Salary drawn
Temporary

Trainee

Contractual

Please tick mark the documents submitted for this employment

Service Certificate Relieving letter Offer letter Any Other
None (please specify)

Kindly Draw your present Organization chart indicating your position clearly
Previous Employment History (last 2 employers)- Please attach a copy of your relieving letter/service certificate

Note: Ensure that you are descriptive wherever necessary – e.g. If Co. is closed, do mention it. Employee Code/ ID/ Number is mandatory. If your previous
employer did not provide one, please mention and state reasons for the same.
Name of Employer (1) Address of Employer

Telephone No Employee Code/No Designation Department

Employer’s Annual Sales & No of employees:

Employment Period Industry Manager's Name Manager's Contact No Manager's Email ID
From To

Duties & Responsibilities Reasons for leaving

First Salary drawn

Was this Position Agency Details (if temporary or contractual), provide details
Permanent
Last Salary drawn
Temporary

Trainee

Contractual
Please tick mark the documents submitted for this employment
Service Certificate Relieving letter Offer letter Any Other
None (please specify)

Previous Employment History (last 2 employers)- Please attach a copy of your relieving letter/service certificate
Name of Employer (2) Address of Employer

Telephone No Employee Code/No Designation Department

Employer’s Annual Sales & No of employees:

Employment Period Industry Manager's Name Manager's Contact No Manager's Email ID

From To

Duties & Responsibilities Reasons for leaving

First Salary drawn Was this Position Agency Details (if temporary or contractual), provide details

Permanent
Last Salary drawn Temporary
Trainee
Contractual
Please tick mark the documents submitted for this employment
Service Certificate Relieving letter Offer letter Any Other
None (please specify)

Please account for any and all gaps in education or employment during your tenure
From To Reason:

Complete Address and Location:

From To Reason:

Complete Address and Location:

From To Reason:

Complete Address and Location:

 OTHER DETAILS
Area of Interests ( Sports / hobbies ):

Have you ever been Interviewed by any of the Matix Group ?

Date/ Year Position Company
Yes
If Yes, Give Details
No

Relatives/ Aqcquaintance in Matix Group

Name Relationship Position Company & Telephone nos

Membership of Professional Institutions

Type of Membership and Name of Institute Duration of Membership
Position held Period From to

Indicate your familarity in Languages by ticking

Read Write Speak

Mother Tongue

Indian Language
Language 1
Language 2
Language 3

Foreign Language
Language 1
Language 2
Language 3

Who referred you to us?

Are you engaged in any personal Yes

If yes, Indicate Nature
business? No

Do you have any Contract / Bond with Yes

If yes,give details
your Present Employer No

Have you ever been involved in any criminal proceedings/ convicted of any offence?
Criminal Record
Yes No If Yes, give details below

Has any disciplinary action been initiated against you in any of your previous employment?
Disciplinary action
Yes No If Yes, give details below

Emergency Contact Person: __________________________________________________________________________

Address : __________________________________________________________________________
email address : __________________________________________________________________________
Telephone Number : __________________________________________________________________________

References: Please provide the details of three professional references ( other than an Relative, preferably an IAS/Govt official)
Reference (1)
Name
Company & Position :
Address:

Contact Details

How do you know this person?

Reference (2)
Name
Company & Position :
Address:

Contact Details

How do you know this person?

Reference (2)
Name
Company & Position :
Address:

Contact Details

How do you know this person?

 INFORMATION ABOUT SALARY AND PERKS IN EXISTING COMPANY

Components Per Month Per Annum

BASE SALARY
Basic
Special Allowance
House Rent Allowance/ Housing Allowance
DA
Conveyance
Education Allowance
Any other Monthly Allowance
1)
2)

ANNUAL COMPONENTS
Performance Linked Incentive/ Bonus
Ex- Gratia
Loan
Any other Annual Component
1)
2)

REIMBURSEMENTS
Medical Reimbursement
Car Operating Expenses/ Local Travelling Expenses
LTA
Others

RETIRALS AND BENEFITS

Provident Fund
Super Annuation
Gratuity

Medical Insurance

Others

ANY OTHERS

COST TO COMPANY
Any other details which you would like to specify
Expected CTC:____________________

Notice Period for Joining_________________________________

Bank details
Bank name & branch
Bank Account no

Documents Required
Education:
Photocopy of degree certificate and final mark sheet
For Bangalore University
A photo copy of both sides of Degree Certificate
Copies of Marks sheet/Grade card for all years of attendance
Name of college through which candidate has graduated

Employment
Photocopy of relieving / experience letter

Declaration and Authorization

I hereby authorize Matix Group(or a third party agent appointed by the Company) to contact any former employers as indicated above and carry out all Background
Checks not restricted to education and employment deemed appropriate through this selection procedure. I authorize former employers, agencies, educational
institutes etc. to release any information pertaining to my employment/education and I release them from any liability in doing so.

I confirm that the above information is correct to the best of my knowledge and I understand that any misrepresentation of information on this application form may, in
the event of my obtaining employment, result in action based on company policy.

Signature:

Name: Date: