Guljag Industries Limited
Personal Detail Declaration Form

Personal Detail

Name Sex

Address

Permanent Present

Mobile Email

Date of Birth
16.09.1988 / Place of Birth
Jodhpur / Identity Mark
Cut near left side of chin
Marital Status
Single / Date of Marriage / Blood Group
B+ / Nationality
Indian
Languages Known
English, Hindi, Urdu / Height
6 feet / Weigh
80kg
Hobbies
Rail fanning & blogging, internet surfing, music / Spectacle Lens
Left
Right / P F A/C No
Vegetarian/Non-Vegetarian
Non-Vegetarian / Smoker/Non-Smoker
Non smoker / Family Doctor
Dr. Dinesh Kothari / Personal Solicitor
Preference for alcohol (If yes how often do you consume)
Non Alcoholic / Passport No. / PAN No.
AZFPA4806Q
Know Driving?
Yes / Mention Vehicle Name
Hero Honda Splender / License No.
RJ-19/DLC/08/312944 / Renewed on

Educational Profile

Basic Qualification

School/College Attended / Examination Passed
Year / Name of School/College / Date / Degree/ Certificate / Subject / %
2007
2004 / St. Pauls School, Jodhpur
St. Pauls School, Jodhpur / May 2007
May 2004 / Senior School Certificate Exam
Secondary School Certificate Exam / Physics, Chemistry, Maths
General subjects / 50
67.6

Professional Qualification

University/College Attended
Year / Name of Institute / Qualification Obtained / %
2001 / Jodhpur Engineering College & Research Centre, Jodhpur
(Rajasthan Technical University) / B. Tech in Electrical Engineering / 63

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
Sep 2001 / Present / Divya Switchgear / Electrical Design Engineer / Want to grow up / 8000

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

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

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