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Godrej & Boyce Mfg. Co. Ltd.

APPLI C AT I O N

FORM

Recent
Photograph (in
professional
attire)

POST APPLIED FOR : _______________________________

FULL NAME

: Mr. / Ms. __________________________________________________________________

( Surname )
(First Name )
( Middle Name)

ADDRESS FOR COMMUNICATION (Local)

PERMANENT ADDRESS ( Native Place)

Mobile No.:
E-mail ID

Phone :

DATE OF BIRTH : ___ / ___ / _______ PLACE OF BIRTH :_______________NATIONALITY :_____________

DO YOU BELONG TO: SC ______ ST _____ OBC _____ OTHERS ______
LANGUAGES KNOWN : ( Communication Skills )
Languages

Speak

Read

Write

EDUCATIONAL QUALIFICATION:
Qualification
(Starting from
SSC)

Full-time /
Part-time or
Corres.

Duration of Course
From
MM/YY

To
MM/YY

Month &
Year of
Passing

Name & Location of

School/College/Usity/Board
(City & State)

Class /Grade &

Percentage
of marks

Was there any break in your studies? No / Yes (If yes, please mention the reason for the same)
________________No_____________________________________________________________________________________
KNOWLEDGE OF COMPUTERS: _____________________________________________________________________
Contd. ( 2 )

WORK EXPERIENCE: (- Including practical training, if any.

- Please write in chronological order ending with present employment)
Period
From

To

(DD/MM/
YY )

(DD/MM/
YY)

Experience
( in
months )

Name & Location of

Employer / Self Employment

Annual
Cost to
Company

Designation and
Nature of Work

201510

Reasons
for
Leaving
Further studies

BREAKUP OF THE PRESENT / LAST SALARY, BENEFITS & PERQUISITES :

Components
Monthly Benefits

Rs. ( p.m.)
9000

Basic Salary
House Rent Allowance

4500

Medical Expense Reimbursement

Education Allowance

Lunch / Canteen

Conveyance Allowance

1500

Telephone Expense Reimbursement

Other Allowances:

Components
Annual Benefits

Rs. (p.m.)
-

Leave Travel Allowance (LTA)

Mediclaim / Hospitalisation Insurance
( Coverage Amount Rs. __________)
Any Other

TOTAL ( B ) :

Terminal Benefits

a)

Provident Fund

b)

Gratuity

72105( for 23
months)
-

c)

Superannuation

d)

Any Other

TOTAL ( C ) :

72105

TOTAL ( A ) :

15000

Cost to Company ( p.a.) :

______________________

( A + B + C ) X 12

Rs. __201510 ______________ /-

PAN Card No. :

Expected Remuneration : Monthly Gross : Rs. _____35000________ Cost to Company ( p.a.) : Rs. ________________
REFERENCES : ( Name of the relatives / acquaintances in any of the Godrej establishments )
Name

Division/Plant, Department & Location

(Specify State & District )

Relationship with
the applicant

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Contd ( 3 )

SOURCE OF RECRUITMENT (DETAILS OF YOUR INTRODUCTION TO US):

Self / Placement Consultant / Advertisement (Newspaper / Godrej Website / Any other Job Portal) / Campus Interview /
Employee Reference / Job Fair / Walk-in / Employees Son / Daughter / Ex-Trainee (Summer / Project / In-Plant) / Temp. Staff.
Please mention the exact detail here: _____________________Campus Interview_______________________________ (For
example, if you are referred by a Placement Consultant, please mention the name of the Firm / Agency).
Please explain in brief why you consider yourself suitable for the position applied for ?
a.
b.
c.

First hand experience in handling sales of the organization

Understood the market dynamics while working as an intern at Reliance Fresh
Handle the sales for my family business

Which functional area do you prefer ? ________________Sales________________________________________

( List in order of preference. E.g. Sales, Service, Production, Quality Control, Design, Maintenance etc)
Are you planning for higher studies ? If yes, please specify _______________________________________
Weekly off day(s) in your present employment : ____1___________________________________________
Have you been previously tested / interviewed by us ? If yes, state when & for what post ? Yes / No

_________________________________________________________________________
How soon would you
__possible_______________

be

able

to

take

up

the

new

appointment, if

selected ? _____As soon _as

DECLARATION
I declare that the foregoing information is correct and complete to the best of my knowledge and belief and nothing has been concealed.
I accept that the statement made by me and the information supplied by me shall form the basis of my employment / traineeship with
the Company. If at any point in time in future, I am found to have concealed any material information or given false details against any
of the above particulars, my appointment / traineeship shall be liable to summary termination without notice or payment in lieu of
notice.

Date

: ___/ ___/ ________

_________________________

Place : ________________

(Signature of the Applicant)

Note:
1.

If appointed, you are liable to be posted and/or transferred to any of the Companys Establishments
within the Territories of India.

2.

All appointments are subject to the candidate being declared medically fit by the Companys Medical
Officer or a Medical Practitioner of Companys choice. The Managements decision in this regard is final.
(For office use only)

GI Raw ________ GI Stanine _________ MC Raw _______ MC Stanine ________ Written English: __________
1-2-3 Raw ____________________ 1-2-3 Stanine ___________________________ 16 PF _____________________
Date of Test: ___________________ Conducted by: _______________________ Signature: ____________________

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Special approval (if any) by Head - HR _______________________________________________________________