Particulars to be submitted for selection process for Redington India Limited and or for their subsidiaries: Full Name:

B-School Name: Permanent Residential Address :( with telephone number and pin code) Age:_______yrs_____month

Place of domicile: Brother /s- Name /occupation

Sister/s Name/ occupation

Fathers occupation and job details including designation & place of work:

Mothers occupation and job details including designation &place of work:

Whether you have own house in the place of domicile or elsewhere:

Other immovable properties if any:

Monthly income of the family: in Rs. Of Which Father: Mother: Brother /s (if residing with parents)

Sister/s (if residing with parents)

Any other income (like rent etc.)?

Full Name: Qualification details: % of marks X th th 12 Degree________ MBA Others Others No of attempts

B-School Name:

University/College

Year of passing

Specialisation

Project Details: Name of the project Period Name of the company

Whether you have taken any education loan? If yes provide the following details For Which Course- Course name Amount of Loan Rs. Repayment to start from the month of EMI Rs.

Do you own 2/4 wheeler? YES/ NO Do you have driving license: 4 Wheeler/ 2 Wheeler? Did /Do you have health problems/ physical ailments/ limitations for movement/ travel (including any surgeries underwent in the past)

State your constraints if any for placement PAN INDIA?

Have you understood the job role and specification clearly? Are you clear about the compensation package? Are you able to speak Hindi? If not how will you manage if posted to Hindi Geography? / When will you be proficient in Hindi?

Full Name: Previous experience if any Name of the organization Job Role/ function

B-School Name:

CTC ( Rs in lakhs)

Period (From-To)

Reasons for leaving

What is your weakness and how you will you address?

Though the posting shall be at the sole discretion of the company, given a choice, where you would like to be placed? (Please note that by giving an opportunity to express your choice, we do not assure the placement in your place of choice and you may still be posted in any of companys subsidiaries/ locations in India? (Indicate in the order of preference, four places) 1. 2. 3. 4. I hereby confirm that I have clearly understood the job role/ responsibilities and if selected I agree/ understand the following: 1. 2. I will serve Redington India Limited for a minimum period of 2 years and submit a suitable undertaking as demanded by the Company as well as to the College authorities. In case of default on my part to fulfill the minimum service of 2 years, I am aware that I am liable to pay to the company upfront the following amounts: Cost of training and other induction cost Amount equivalent to the fixed monthly salary for the un-served period subject to a minimum of 11 months salary I will surrender all the original education certificates/ mark lists which will be returned only after the period of 2 years I will also provide a security cheque for Rs.256000/- towards the conditions of the two years bond.

I also undertake not to withdraw my candidature from the selection process.

Name: Place:

Signature: Date: