Guljag Industries Limited
Personal Detail Declaration Form
Personal Detail
Name Sex
Address. PIRALLIPUR CHUNAR MIRZAPUR
Permanent Present
Mobile Email
Date of Birth
Place of Birth
CHUNAR
Identity Mark
PIRALLIPUR
Marital Status
SINGLE
Date of Marriage
Blood Group
Nationality
INDIAN
Languages Known
HINDI ENGLISH
Height
178
Weight
65
Hobbies
BADMINTON
Spectacle Lens
Left
Right
P F A/C No
Vegetarian/Non-Vegetarian
NON Vegetarian
Smoker/Non-Smoker
Non smoker
Family Doctor
Personal Solicitor
Preference for alcohol (If yes how often do you consume)
N/A
Passport No.
PAN No.
Know Driving?
Yes
Mention Vehicle Name
License No.
Renewed on
Educational Profile
Basic Qualification
School/College Attended
Examination Passed
Year
Name of School/College
Date
Degree/ Certificate
Subject
%
2010
2012
S M P A I C SATIDHAM RAIPURI CHUNAR MIRZAPUR
P D N D INTER COLLEGE CHUNAR MIRZAPUR
28/06/2010
30/06/2012
HIGH SCHOOL
INTERMEDIATE
HINDI
ENGLISH SCIENCE MATHEMATICS
SOCIAL SCIENCE
ART
MATHEMATICS
PHYSICS
CHEMISTRY
HINDI
ENGLISH
67
58
Professional Qualification
University/College Attended
Year
Name of Institute
Qualification Obtained
%
2013- 2016
GOVERNMENT POLYTECHNIC PILIBHIT
DIPLOMA IN INSTRUMENTATION AND CONTROL ENGINEERING
73.39
Additional Course
Employment History (Beginning with present or most recent employer)
Date
Name of organization
Post held & Job Responsibilities
Reason for leaving
Salary on leaving
From
To
24/11/2016
25/09/2019
JAYPEE CEMENT
INSTRUMENTATION TECHNICIAN
NO INCREASE IN SALARY
16000
Award/Achievement
Key Skill Set
Your Suitability for the job (e.g. present your strength and weakness)
Family Background
Family Members
Father Name & Occupation Mother Name & Occupation
Brothers Name & Occupation
Sisters Name & Occupation
Family (Joint/Nuclear) Total Members No. of earning members
Dependents:
Name
Age
Relationship
MEWALAL YADAV
61
FATHER
Accomodation (Own/Rented) Rent Amount
Any relative working at any senior position in Government Department or in Private Sector, if any (give detail)
Applicable if married
Spouse Name & Occupation
Father in law - Name & Occupation Mother in law - Name & Occupation
Children
Name
Age
Education
Are you known to any employee of Guljag Industries Limited? If yes (give detail)
S
References
Please give the contact details of two people who will be able to comment on your suitability.
Name Name
Address Address
Telephone Telephone
Email Email
Membership of Professional Institution
Name of Institution
Membership Status
Admission Date
Joining Us
Have you been interviewed in this company before?
For how long, would you commit to work with us?
Period of notice required in the present post
Expected Minimum Salary
I declare that the information given in this form is correct and to the best of my knowledge.
Signed Name
Date
For office use only:
Date of joining: DASD
Salary at the time of joining:
Designation at the time of joining:
Training / Probation period:
Remarks, if any: -
Personnel/ Admin Manager Sr. V P - Works Managing Director
MALE
BHIM KUMAR
PIRALLIPUR CHUNAR MIRZAPUR
Telephone No
PIRALLIPUR CHUNAR MIRZAPUR
Telephone No
***********@*****.***
Maintenance and repair
No
Forever
7 days
25000
BHIM KUMAR
5/09/2019