CANDIDATE CATEGORY: (Please tick (√) the relevant category)

FRESHER ( )

LATERAL ( )

REHIRE ( )

POSITION APPLIED FOR:	Unit:	Date:

A: Personal Details:

Name: In Block Letters
	First	Middle	Surname

Present Address:	Permanent Address:

Date of Birth:		Age:		Place of Birth:
Marital Status:		Religion:		Nationality:
Tel No (Res):		Tel No (Off):		Mobile No:
E-mail id:				Voter ID No
Pan No:		Passport No/ Validity:

Proof of residential Address:
(E,g. copy of Voter Card/ Ration Card/Telephone bill/ Rent lease/ Receipt etc.): - – Will be submitted whenever desired.
(Please Tick (√) wherever applicable)

Language	Can Speak	Can Read	Can Write
1. English
2. Hindi
3. Others

Near relation	Name	Age	Gender	Education	Employment

Family /Dependent number and monthly living cost:        
Have own House /Rental House if rental then paying Rs: / monthly rental
B: Educational Details

Education	Name of the qualification awarded	Passing year (mm/yyyy)		School/College/ University	Subject/ Specialization	% or CGPA (Rank if any)
		From	To

Significant Achievements:
Extra Curricular Activities (NCC/Student Unions/Sports etc.):
Training & Special courses attended during professional career:
C: Professional Details:

Duration (Mm/yyyy)		Organization with address	Last position held	Total Remun eration P.A. (*)	Reason for leaving
From	To

Professional Membership:
Name Address of Professional Institutions/Social Organizations	Grade	Level of involvement

Significant contribution made in your existing job so far:

Please draw below the organization chart of the present company, clearly indicating your level and direct report:	Please give us a detailed description of your current job responsibilities:
Notice period required to join:	Minimum Salary Expected:

What prompted you to apply to our company and what is your career vision:
Details of any Director positions held in any company (including any family members):

How did you come to know of opportunities in HCC? Was it through the following?

Search Firm	( )	Recruitment Consultant	( )	Print Media Advertisement	( )
Employee Referral	( )	Internet Job Board	( )	Company Website	( )
Other (Please Specify):	( )
Any Locations constraints (Please specify):
Have you ever undergone selection process with HCC? Yes ( ) No ( ) If Yes, :-
Position Applied for:				Year:
Were you selected for an interview?				Yes ( )	No ( )
Were you made an offer?				Yes ( )	No ( )
Were you previously employed with us?				Yes ( )	No ( )

List two references, other than relatives (preferably your immediate superior/previous organization.
Name	Designation	Organization	Telephone/Mobile/Email

Do you have any relatives/Friends in this company/Sister concern:	Yes( )	No( )
If yes, please mention the name (s), Company, Location, Department, Designation, and nature of Relationship.

Any additional information, which you feel, will be helpful to us in considering application for employment with us:

D: Current Compensation Work Sheet
Name:	Current Employer:
Position:	Location:

Components Details	Existing (Rs.)
(I) Monthly Payments – converted to Annual
BASIC PAY – Annual
HRA (40/50 % OF BASIC)
CONVEYANCE REIMBURSEMENT
UNIFORM WASHING ALLOWANCE
PERSONAL ALLOWANCE
FOOD COUPONS(ETC) upto 1300/-
BONUS
(II) Annual Payments
PROVIDENT FUND CONTRIBUTION (12 % OF BASIC)
MEDICAL EXPENSES REIMBUSEMENT
LTA (ONE MONTH BASIC)
GRATUITY(As per law)
TOTAL ANNUAL PAYMENTS (II)
GRAND TOTAL -ANNUAL CTC

NOTES OF OTHER BENEFITS, WHICH ARE NOT INCLUDED ABOVE

I hereby certify that all the information provided above is true and correct to the best of my knowledge. Any false or misleading information provided on this form or any other document may result in the employment being terminated.

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