Regd.Office :
Jindal Mansion, 5-A, G. Deshmukh Marg, Mumbai 400 026.
Tel. : 496 3000 / Fax : 91-22-496 1400.
APPLICATION FOR EMPLOYMENT
We appreciate your interest in being associated with the Jindal Organisation and wish to give careful consideration to your application.
All information given below will be held in strict confidence.
1.
POSITION APPLIED FOR
EDUCATIONAL QUALIFICATIONS
2.
NAME
Mr.
Mrs.
Ms.
(First Name)
(Surname)
(Middle Name)
3.
CONTACT TELEPHONE NO.
3a.
BLOOD GROUP
- - select - -
A RH +ve
A RH -ve
B RH +ve
B RH -ve
O RH +ve
O RH -ve
AB +ve
AB -ve
4.
PRESENT ADDRESS
5.
PERMANENT ADDRESS
CITY
CITY
STATE
- - - - - select - - - - -
Andhra
Arunachal Pradesh
Assam
Bihar
Delhi
Gujarat
Goa
Haryana
Himachal Pradesh
Jammu & Kashmir
Karnataka
Kerala
Madhya Pradesh
Maharashtra
Manipur
Meghalaya
Mizoram
Nagaland
Orissa
Punjab
Rajasthan
Tamil Nadu
Tripura
Uttar Pradesh
West Bengal
STATE
- - - - - select - - - - -
Andhra
Arunachal Pradesh
Assam
Bihar
Delhi
Gujarat
Goa
Haryana
Himachal Pradesh
Jammu & Kashmir
Karnataka
Kerala
Madhya Pradesh
Maharashtra
Manipur
Meghalaya
Mizoram
Nagaland
Orissa
Punjab
Rajasthan
Tamil Nadu
Tripura
Uttar Pradesh
West Bengal
TEL.NO.
TEL.NO.
E-MAIL
E-MAIL
4a.
HOUSING
- - - select - - -
With Parents
With Relatives
Rent
Board
Own
Other
IF OTHER SPECIFY
6.
DATE OF BIRTH
DD
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
MM
01
02
03
04
05
06
07
08
09
10
11
12
YYYY
1940
1941
1942
1943
1944
1945
1946
1947
1948
1949
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
7.
AGE
YRS
8.
PLACE OF BIRTH
9.
NATIONALITY
10.
PASSPORT NO.
11.
DRIVING LICENCE NO.
12.
MARITAL STATUS
- - - select - - -
SINGLE
MARRIED
SEPERATED
WIDOWED
13.
FAMILY DETAILS
Relation
Name(s)
Age(s)
Education
Level
Occupation/
Designation
Dependant
Father
Yes
No
Mother
Yes
No
Spouse
Yes
No
Children
Yes
No
Children
Yes
No
Children
Yes
No
Children
Yes
No
14.
ARE YOU RELATED TO ANYONE WORKING IN THE JINDAL ORGANISATION ?
Yes
No
(Name)
(Designation)
(Relationship)
15.
NAME AND ADDRESS OF PERSON TO BE CONTACTED IN CASE OF AN EMERGENCY.
NAME
RELATIONSHIP
ADDRESS
TEL. NO.
EDUCATIONAL QUALIFICATIONS
16.
BEGIN WITH HIGHEST QUALIFICATION & STATE ABBREVIATIONS TOO
Name of School/
College/Institute
(Location)
Period
Degree/Diploma Obtained
Principal
Subject (s)
Grade/Class
/ Marks %
FROM
TO
MM
01
02
03
04
05
06
07
08
09
10
11
12
YYYY
1940
1941
1942
1943
1944
1945
1946
1947
1948
1949
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
MM
01
02
03
04
05
06
07
08
09
10
11
12
YYYY
1940
1941
1942
1943
1944
1945
1946
1947
1948
1949
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
MM
01
02
03
04
05
06
07
08
09
10
11
12
YYYY
1940
1941
1942
1943
1944
1945
1946
1947
1948
1949
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
MM
01
02
03
04
05
06
07
08
09
10
11
12
YYYY
1940
1941
1942
1943
1944
1945
1946
1947
1948
1949
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
MM
01
02
03
04
05
06
07
08
09
10
11
12
YYYY
1940
1941
1942
1943
1944
1945
1946
1947
1948
1949
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
MM
01
02
03
04
05
06
07
08
09
10
11
12
YYYY
1940
1941
1942
1943
1944
1945
1946
1947
1948
1949
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
MM
01
02
03
04
05
06
07
08
09
10
11
12
YYYY
1940
1941
1942
1943
1944
1945
1946
1947
1948
1949
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
MM
01
02
03
04
05
06
07
08
09
10
11
12
YYYY
1940
1941
1942
1943
1944
1945
1946
1947
1948
1949
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
16a.
AWARDS/DISTINCTION/RANK/
SCHOLARSHIP RECEIVED
17.
IF THERE WERE BREAKS IN YOUR EDUCATION, GIVE DETAILS
18.
ANY OTHER CERTIFICATE/PROFESSIONAL COURSE UNDERTAKEN
Period
Place of Training
Stipend/Salary
(If any)
Nature of Training
From
To
MM
01
02
03
04
05
06
07
08
09
10
11
12
YYYY
1940
1941
1942
1943
1944
1945
1946
1947
1948
1949
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
MM
01
02
03
04
05
06
07
08
09
10
11
12
YYYY
1940
1941
1942
1943
1944
1945
1946
1947
1948
1949
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
MM
01
02
03
04
05
06
07
08
09
10
11
12
YYYY
1940
1941
1942
1943
1944
1945
1946
1947
1948
1949
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
MM
01
02
03
04
05
06
07
08
09
10
11
12
YYYY
1940
1941
1942
1943
1944
1945
1946
1947
1948
1949
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
MM
01
02
03
04
05
06
07
08
09
10
11
12
YYYY
1940
1941
1942
1943
1944
1945
1946
1947
1948
1949
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
MM
01
02
03
04
05
06
07
08
09
10
11
12
YYYY
1940
1941
1942
1943
1944
1945
1946
1947
1948
1949
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
19.
LANGUAGE PROFICIENCY
Languages
(Check your Mother Tongue)
Read
Speak
Write
Good
Fair
Slight
Good
Fair
Slight
Good
Fair
Slight
Good
Fair
Slight
Good
Fair
Slight
Good
Fair
Slight
Good
Fair
Slight
Good
Fair
Slight
Good
Fair
Slight
Good
Fair
Slight
Good
Fair
Slight
Good
Fair
Slight
PROFESSIONAL EXPERIENCE
20.
Have you worked before
Yes
No
(If Yes then complete the following points or attend point No. 26)
Name and Complete Postal Address of Employer
Period
Position Held
Salary
(include allowances)
Major Activities Undertaken
From
MM
01
02
03
04
05
06
07
08
09
10
11
12
YYYY
1940
1941
1942
1943
1944
1945
1946
1947
1948
1949
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
At Start
At Start
To
MM
01
02
03
04
05
06
07
08
09
10
11
12
YYYY
1940
1941
1942
1943
1944
1945
1946
1947
1948
1949
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
At End
At End
From
MM
01
02
03
04
05
06
07
08
09
10
11
12
YYYY
1940
1941
1942
1943
1944
1945
1946
1947
1948
1949
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
At Start
At Start
To
MM
01
02
03
04
05
06
07
08
09
10
11
12
YYYY
1940
1941
1942
1943
1944
1945
1946
1947
1948
1949
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
At End
At End
From
MM
01
02
03
04
05
06
07
08
09
10
11
12
YYYY
1940
1941
1942
1943
1944
1945
1946
1947
1948
1949
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
At Start
At Start
To
MM
01
02
03
04
05
06
07
08
09
10
11
12
YYYY
1940
1941
1942
1943
1944
1945
1946
1947
1948
1949
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
At End
At End
From
MM
01
02
03
04
05
06
07
08
09
10
11
12
YYYY
1940
1941
1942
1943
1944
1945
1946
1947
1948
1949
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
At Start
At Start
To
MM
01
02
03
04
05
06
07
08
09
10
11
12
YYYY
1940
1941
1942
1943
1944
1945
1946
1947
1948
1949
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
At End
At End
21.
IF THERE WERE ANY BREAKS IN YOUR CAREER, GIVE DETAILS
22.
PLEASE GIVE DETAILS SHOWING REPORTING RELATIONSHIP IN PRESENT EMPLOYMENT
23.
STATE BRIEFLY YOUR PRESENT RESPONSIBILITIES
24.
STATE TWO OUTSTANDING ACHIEVEMENTS IN YOUR PRESENT EMPLOYMENT
25.
SALARY DETAILS OF PRESENT EMPLOYMENT
A)
LAST DRAWN EMOLUMENTS
MONTHLY
ANNUAL
BASIC
:
Rs.
GROSS TOTAL
:
Rs.
EDUCATION
:
Rs.
LTA
:
Rs.
HRA
:
Rs.
BONUS
:
Rs.
ANY OTHERS (Specify)
P.F.
:
Rs.
a)
:
Rs.
ANY OTHERS (Specify)
b)
:
Rs.
a)
:
Rs.
c)
:
Rs.
b)
:
Rs.
d)
:
Rs.
c)
:
Rs.
e)
:
Rs.
d)
:
Rs.
GROSS TOTAL
(per month)
:
Rs.
GROSS EMOLUMENTS
(per annum)
:
Rs.
B)
BENIFITS
(i)
MEDICAL-DOMICILIARY
:
SELF Rs.
FAMILY Rs.
HOSPITAL
:
SELF Rs.
FAMILY Rs.
(ii)
LOAN SCHEMES
:
(iii)
ANY OTHER BENIFITS
:
26.
STATE SALARY EXPECTED (per annum)
:
Rs.
27.
WHEN CAN YOU JOIN IF SELECTED ?
28.
ARE YOU A MEMBER OF ANY PROVIDAND FUND ?
Yes
No
IF YES, STATE YOUR ACCOUNT NO.
:
OTHER INFORMATION
29.
WHAT ARE YOUR HOBBIES ?
30.
WHAT GAMES DO YOU PLAY ?
31.
ARE YOU A MEMBER OF A SPORTS CLUB OR AN ASSOCIATION ?
Yes
No
IF YES, GIVE DETAILS
32.
ARE YOU A MEMBER OF ANY PROFESSIONAL BODY ?
Yes
No
IF YES, GIVE DETAILS
33.
ARE YOU IN DEBT ?
Yes
No
IF YES, GIVE DETAILS
34.
HAVE YOU BEEN PROSECUTED IN A CRIMINAL COURT ?
Yes
No
IF YES, GIVE DETAILS
35.
HAS DISCIPLINARY ACTION BEEN TAKEN AGAINST YOU IN ANY PREVIOUS EMPLOYMENT?
Yes
No
IF YES, GIVE DETAILS
36.
ARE YOU WILLING TO BE POSTED ANYWHERE IN INDIA ?
Yes
No
37.
HAVE YOU APPLIED TO THE JINDAL ORGANISATION BEFORE ?
Yes
No
IF YES, GIVE DETAILS
38.
DO YOU HAVE ANY UNUSUAL MARKS OR SCARS
Yes
No
IF YES, GIVE DETAILS
39.
ADDITIONAL INFORMATION IF ANY
REFERENCES
40.
LIST REFERENCES WHO HAVE KNOWLEDGE ABOUT YOUR EMPLOYMENT AND PERSONAL INFORMATION FOR THE PAST 4 YEARS.
NAME
FULL POSTAL ADDRESS
TEL . NO.
OCCUPATION/
DESIGNATION
DECLARATION
If employed, I agree to abide by and observe all rules and regulation of the Company as prevalent from time to time. I am willing to take medical examination wherever and whenever required. I hereby confirm that the information/ statments given by me in this application form is true. I accept that I shall be liable for dismissal from serviceifnthe same are found to be a misrepresentation of facts at any time during my employment with the company.
PLACE :
DATE :
DD
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
MM
01
02
03
04
05
06
07
08
09
10
11
12
YYYY
1940
1941
1942
1943
1944
1945
1946
1947
1948
1949
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000