SCREEN FORM

Please read the instructions carefully before Filling out this form

1. First Name:

Middle Name:

Last Name:

2. Contact No. (Residence): 3. Email Id:

* *

Mobile No.

4. How did you get to know about this Vacancy?

If Others:

5. If you are referred by any Conceptz Students, Student Name: 6. Are you related to any of Student Placed by Conceptz(s)? If Yes, Student Name:

Student ID:

Yes

Student ID:

Relationship:

7. Reason for pursuing opportunities: 8. IT/ITES Experience: 10. Key Skills: 0 Years

*
Months 9. Non-IT/ITES Experience: 0 Years 0 Months

Skill 1: Skill 4:

Skill 2 Skill 5

Skill 3

11. Current Salary (Annual CTC):

*
1 1 2008

Expected Salary (CTC):

12. If selected can join on or before: 13. Willing to travel: No

* or mention approximate Date:

14. Location preferred:

Bangalore

15. Current offer in hand:

16. Non-compete agreement / under contact with current employee?

Yes

If yes, give details:

Yes

17. Have you attended an interview with Conceptzs Client in last 3 months?

If yes, give details:

18. Give two references other than relatives (Conceptz can contact them, if required): Name: Designation: Organization: Phone No: Email id:

Name: Designation:

Organization: Phone No: Email id:

INSTRUCTIONS
Note:

Please switch on the macros before filling out this form. You can do this by going to the Tools -> Macro ->Security and set the options as Low. Close the word application and reopen.(For Word 2007: Go to Office Button->Word Options -> Trust Center->Trust Center Settings -> Macro Settings -> Enable All Macros )

Fields mentioned as * are mandatory.

1. 2.
3.

Enter your First name followed by second name and then last name. In case you dont have any Middle name or last name, leave the field blank. Enter your Mobile or landline number with STD code and extension. Enter your valid Email ID.

4. 5. 6.
7.

Mention about how you came to know about the vacancy. If you select Others option then mention the source. If you are referred by any Student employee, enter Student name and Employee ID.

If you are related to Conceptzs Student, enter the Relative name, Relative ID and Relationship with the employee. Enter the reason for pursuing the opportunities. Enter your IT/ITES (Information Technology/ Information Technology Enabled services) experience. Enter your Non-IT/ITES experience.

8.
9.

10.
11.

Enter your skills in the fields mentioned skill-1 through skill-5. Skill1 is mandatory and it will be considered as your primary skill Enter your current and expected salary. If you are selected then, enter the date on which you can join Mention whether you are willing to travel or not? Mention the location that you prefer. Mention, if you have any current offer in hand. Mention the Non-compete agreement / under contract with current employee. Give details if yes. Mention, if you have attended any interview in Conceptzs Client in the last 3 months. If yes give

12. 13. 14. 15. 16. 17.

details.

18.

Give any two reference details other than relatives, So that Conceptz can contact if required.