I. Personal Details: Reference Code / Sr. #
I. Personal Details: Reference Code / Sr. #
Photo
I. Personal Details
Name: Mr/Mrs/Ms
(as in your passport) Last First Middle
*
Date of Birth: DD/MM/Y
Mother Tongue: Present Address: City: Business Tel No: Permanent Address: City: Emergency Contact details Emergency Contact Current Address: City: PAN #: Driving License #: Passport #: State: Existing HDFC Saving Account #: Expiry Date: Place of Issue: If Y, If Y, Name: State: Mobile: State:
Pincode:
Pincode:
Have you ever applied for a Work Permit/Visa: Y/N Have you ever been rejected a Work Permit/Visa: Y/N
Languages Known
Written
Spoken
Date of Birth
Occup
Mother's Name
Spouse Name
IX. Have You Been Interviewed by any of the Capgemini Group company within the last 6 months? Y/N
If Y, When (mm/yy): Which group co.: What was the outcome?
XI. References
Professional Name Relationship Years Known Company Name Title or Occupation Home Tel No Business Tel No Professional Personal Personal
Monthly Gross
INR 0
Annual Gross
INR 0
Declaration I, hereby declare that the above information provided by me is true and accurate to the best of my knowledge. I was never arrested by the police or have a criminal record. I also have got my self medically examined within last 3 months and declare that I am medically fit . I have no communicable disease and I am not addicted to drugs or substance abuse. Any falsification of this information will hold me liable to the action taken against me by the organisation as per its prevailing rules and regulations.
PLACE:
VADODARA
DATE:
14-Apr-10
SIGNATURE: