GUJARAT CORPORATE SOCIAL RESPONSIBILTY AUTHORITY (Initiative by Government of Gujarat) APPLICATION FORM FOR EMPLOYMENT

Transcription

1 GUJARAT CORPORATE SOCIAL RESPONSIBILTY AUTHORITY (Initiative by Government of Gujarat) APPLICATION FORM FOR EMPLOYMENT Please affix your recent passport size color photograph 1. POST DETAILS Post applied for: 2. PERSONAL DETAILS (in BLOCK letters) First Name: Middle Name: Last Name: Date of Birth (DD/MM/YYYY): Father s/ Spouse s Name: 3. CATEGORY (Tick in appropriate box) SC ST OBC(NCL) GEN Name of the Caste/ Tribe: (In case of SC/ ST/ OBC)

2 4. DETAILS OF DISABILITY (In case of PH) (Tick in appropriate box) (i) Type of Disability OH VH HH (ii) Percentage (%) of Disability: 5. Nationality: 6. Sex : Male Female 7. Marital Status: 8. i. Present Postal Address PIN ii. Permanent Postal Address PIN Telephone (Landline): STD CODE: Number: Telephone (Mobile): 9. Present ID :

3 10. DETAILS OF FAMILY MEMBERS (only include parents, if dependant) Sr. No Name of Dependant Family Members Relationship with Applicant Date of Birth Married/ Unmarried Occupation Income from all Sources (PM) Father s Name: Address: Occupation: Have you ever been called to a police station or arrested at any time or have been dismissed/discharged/terminated/suspended OR punished for any Act. Of misconduct in any of previous employment? If yes, please give compact precise details on a separate paper. YES / NO Mother Tongue: Language known English Hindi Gujarati I. Read II. Write III. Speak

4 11. EDUCATIONAL DETAILS Exam / Degree Passed Branch/ Discipline School/ College/ Institution Year of Joining Year of Passing Board / University Percentage of Marks obtained Mode (Full time / Part time / Distance Mode 12. OTHER QUALIFICATION Course Institution University Passing Year Percentage

5 Do you posses any special technical skill? (Specify them): Give details of special qualifications such as a research work of professional training of publication and details of patents taken (if any): List of any special interests or hobbies or extra curricular activities with position/responsibilities held: Please describe most outstanding achievement of your life.(you may please use separate sheet) Are you willing to work anywhere in Gujarat? If appointed, how soon can your join? Please state any information(in not more than 50 words) you feel relevant to your application, if you are offered the job, its acceptance might face you with some embarrassing decision, You may like to state any consideration(economic, domestic social or another) :

6 13. EMPLOYMENT RECORD : Period of company s training / Apprenticeship to be specifically mentioned: Sr.No Name and address of industry/organization office and nature of industry Period of employment Designation & Period Nature of duties Name & Designation of your immediate supervisor Cost of the Company Reason for leaving Please give name & address of two persons, not related to you, to whom reference can be made. Name Occupation Postal Address Years Known 1 2 Please describe the jobs / assignments handled by you in present/past employment and any important /memorable achievement recognition:

7 Please draw organization chart showing your position whom you report and persons who are reporting to you, in present employment: Any relatives or acquaintances working in this Authority or on the Governing Body? If so, please state their names, designation and office in which they are working. Have you applied or been interviewed before in this company? If yes, when? For which post?

8 14. PLEASE STATE DETAILS OF YOUR PRESENT CTC IN THE FOLLOWING FORMAT : Name : Sr. Components Monthly Annually Description/Remarks No A Fixed Pay 1 Basic 2 Dearness Allowance B Allowances 1 HRA 2 Washing Allowance 3 Medical reimbursement 4 Canteen Allowance 5 Transport Allowance/ Conveyance 6 Education Allowance 7 LTA 8 Variable Spl. Allowance 9 Other Allowance if any C Retrials 1 PF 2 Gratuity 3 Superannuation 4 Other if any 5 6 D Fringe Benefits 1 Bonus ( Including Exgratia) 2 Group Ins. Premium 3 Mediclaim 4 Other if any 5 6 Perks like uniform, Civil Shoes, Subsidized Housing Loan, Education Loan, Medical facilities for self, Spouse, children and Dependent Parents etc. E Performance Pay/ Variable Pay F Total CTC per Annum (A+B+C+D+E) Attach a copy of last pay slip/ proof of Salary + Perks)

9 15. PARTICULARS OF POST QUALIFICATION EMPLOYEMENT EXPERIENCE Name of Organization/ Company Location Employment period Post held Pay Details(Per Month) Total Pay P.M. From To Pay Scale From Pay Scale To Basic Pay 16. QUESTIONNAIRE Sr. No Question- Answer 1 Describe Personal Strength and weakness. 2 Describe the qualities you are known for. 3 Describe your long term and short term vision with a brief outline of roadmap. 4 Describe you as a professional with critical analysis. 5 Tough decisions you made in personal/professional life. 6 Professional incidents where you faced ethical dilemmas. 7 Training needs that can improve your professional skills. 8 What are the supervisor s feedbacks in past organizations.

10 9 Please give brief description of noteworthy contribution by you during last 3 years. 10 Functional skill set Communication Presentation Analytical Negotiation Reasoning 11 Behavioral skill set Interpersonal Counseling Adaptability Multitasking Grievance handling Stress Management Leadership 12 Area of exposure Operations Maintenance Utilities Process Process Quality Development Improvement Control Process Project Quality Planning Implementation Assurance Financial Financial Legal Cost accounting Auditing Liaison Human Training Resource Development Administration 13 What contribution can you make in proposed area if selected? Separate row should be used for experience in case of change in grade/ designation due to promotion in the same company [Please provide details of experience starting from present with Pay Scales. In case you have served at different positions (on account of promotion in a particular organization then, please give details of different positions held in that organization with dates and Pay Scales] Original document to be verified during job At this stage of candidate is required to attach CV along to his/her application 17. DECLARATION I solemnly declare that information given above is true, complete and correct. I understand that any false information or concealment of relevant information may provide grounds for summary dismissal from services, If employed. Place: Signature: Date : Name: N. B.1. If the space above is insufficient, please attach, separate pages of the same size. 2. Attach CV along with this application.