APPLICATION FORM

Thank you for the interest shown in VirtusaPolaris. Please take a few minutes of your time to
fill in the following details to help us understand your technical skills and personal
competencies better.

Please keep in mind the following when filling up the form: Paste your
1. Fill in the boxes in the application blank in bold capital Passport
Letters unless the content is of a descriptive nature.
Size
2. Fill in the details according to the format mentioned
For the date and day. Photograph

NAME (As in Passport) ______SAI KRISHNA______________/_________KUNAPUREDDY_________________

Given Name Surname

Father’s Name: KUNAPUREDDY KUTUMBA RAO
Nationality: INDIAN Social Security Number (if applicable):
Sex: M Marital Status:NO
Nationality: INDIAN Pan card number: DNAPK2551Q

Place of Birth:GUNTUR
Date of Birth: _____23____/____07____/__1994__________
DD MM YY
ADDRESS Present Address Permanent Address
House No G1 3-136
Locality / City CHILUKURI BALAJI SWAMI BOYS HOSTEL EMANIVARI STREET / KOLLURU
State TELANGANA ANDHRAPRADESH
PIN CODE 500038 522324
Period of Stay
 (Telephone)
 (Mobile Phone) 9704320111
E-mail ID (Personal) 1.saikrishna.k1994@gmail.com 2

Instant Messaging System ID:

Passport Details: Available YES Not Available Applied

Number : N3184913

Date Of Issue :28-09-2015

Date of Expiry :27-09-2025

Place Issue :VISAKHAPATNAM

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HR Dept. - FORMS –Application Form.
 Yes No

Do you have a valid VISA? If yes, please mention the type of Visa

Are you open to Travel to the USA / Sri Lanka on work for a period of 6 months/less during a year?

S.No Languages Known Read Write Speak

1 TELUGU YES YES YES

2 ENGLISH YES YES YES

Family Information (Parents, Brothers, Sisters, Spouse & Children)

S.No Name Relationship Date of Birth Age

1 KUTUMBA RAO FATHER 60

2 DHANA LAKSHMI MOTHER 52

EDUCATION INFORMATION
University
Program (full- Name and Graduation
Degree Course time/Part-time) Elective College Name and Address Address Duration % Date (MM/YY)

From To

X FULL TIME SRI SAI VASAVI VIDYANIKETHAN 2008 2009 83

XII MPC FULL TIME SRI CHAITANYA 2009 2011 78

Graduation
NALANDA INSTITUTE OF
PG CSE FULL TIME ENGINEERING AND TECHNOLOGY 2011 2015 64

Others 1

SSN No. (mandatory if studied in USA or Canada):

* Please mention the last full time degree

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HR Dept. - FORMS –Application Form.
 ADDITIONAL QUALIFICATIONS/ DIPLOMAS / CERTIFICATES / TRAINING
Please mention any Self learned course /Software /Package)

Program Institute Duration % Division

From To

AWS DIGITAL LYNC JAN MARCH

SEMINARS / TRAINING PROGRAMS ATTENDED

Duration
S.No Seminar / Training Program Conducted by
From To
1

MAJOR ACHIEVEMENTS /PUBLICATIONS TO YOUR CREDIT

S.No Description Year

PROJECT INFORMATION (In ascending order give details of the recent projects)
Platform and Team
S.No
Title Company Client Role
Skills used Size
1 ULTRA TECH T&VS UK TESTING 12 TEST ENGINEER

Please name two known contacts who could be friends / co-workers whom you would like to
recommend for Employment at VirtusaPolaris
Name Current Company E-mail address Telephone
1 (Res/Mobile/O)
2 (Res/Mobile/O)

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HR Dept. - FORMS –Application Form.
 Details of Previous Employers (Starting from your Current Job, covering up to Last 3 Employments)
Please attach a copy of your relieving letter/service certificate for this

Company Name (1) : Test and verification solutions india Last Designation held:NOV
pvt. ltd

Address (main office and branch where Telephone:

worked):BANGALURU

Employment Period: (date, month, year) Employee Code/ Personnel Name of Reporting
From: 18-08-2016 To: 20-11-2017 No:TVSIND0227 Manager: CHANDRA
SHEKHAR

Name of HR: SUMATHI Contact No. of HR: Email Id of HR:

Designation & Department of Reporting Manager Contact No of Reporting Email ID of Reporting

Manager: Manager:

Name of Alternative Reporting Manager Contact No of Alternative Reporting Manager:

Designation & Department of Alternative Email ID of Alternative Reporting Manager:

Reporting Manager

Whether employment is of permanent or temporary nature -  Permanent  Temporary

Agency Details (if temporary or contractual)

Remunerations (CTC pa) Reason(s) for Leaving

Details of Previous Employers (Starting from your Current Job, covering up to Last 3 Employments)
Please attach a copy of your relieving letter/service certificate for this

Company Name (2) : Last Designation held:

Address (main office and branch where worked): Telephone:

Employment Period: (date, month, year) Employee Code/ Name of Reporting

From To Personnel No: Manager

Name of HR: Contact No. of HR: Email Id of HR:

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HR Dept. - FORMS –Application Form.
 Designation & Department of Reporting Manager Contact No of Reporting Email ID of Reporting
Manager: Manager:

Name of Alternative Reporting Manager Contact No of Alternative Reporting Manager:

Designation & Department of Alternative Reporting Email ID of Alternative Reporting Manager:

Manager

Whether employment is of permanent or temporary nature -  Permanent  Temporary

Agency Details (if temporary or contractual)

Remunerations (CTC pa) Reason(s) for Leaving

Details of Previous Employers (Starting from your Current Job, covering up to Last 3 Employments)
Please attach a copy of your relieving letter/service certificate for this

Company Name (3) : Last Designation held:

Address (main office and branch where worked): Telephone:

Employment Period: (date, month, year) Employee Code/ Name of Reporting

From To Personnel No: Manager

Name of HR: Contact No. of HR: Email Id of HR:

Designation & Department of Reporting Manager Contact No of Reporting Email ID of Reporting

Manager: Manager:

Name of Alternative Reporting Manager Contact No of Alternative Reporting Manager:

Designation & Department of Alternative Reporting Email ID of Alternative Reporting Manager:

Manager

Whether employment is of permanent or temporary nature -  Permanent  Temporary

Agency Details (if temporary or contractual)

Remunerations (CTC pa): 2.6 LAC Reason(s) for Leaving:

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HR Dept. - FORMS –Application Form.
 Please account for any and all gaps in education or employment during your tenure.

From To Reason: Complete Address and

Location

From To Reason: Complete Address and

Location

From To Reason: Complete Address and

Location

Organization Chart showing your current position in the current assignment

Key responsibilities at current assignment:

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HR Dept. - FORMS –Application Form.
PERSONAL ASSESMENT
Please put down in five succinct points as what you consider your strengths and Weaknesses.
1 MY FAMILY
STRENGTHS

2
3
4
5
WEAKNESSES

1 SOME TIME’S I FRUSTRATED

2
3
4
5

REFEREES - Please give two references of which one should necessarily be from your Present
Work Place.
No of Months /
Name & Designation Current Company Address Contact Details
Yrs Of Acquaintance

* In case your previous employer has closed operations please mention and provide above
names and contact details of your supervisors in the above fields..
Which Sport /Hobby / Activity provides you immense satisfaction? State briefly as to why?

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HR Dept. - FORMS –Application Form.
What are your short term goals?

I WILL PROVE MY SELF AND I WILL LEARNE WHAT TECHNOLOGY WAS USING THE COMPANY.

What are your long term goals?

MY LONG TERM GOAL IS BECOME A GOOD SOFTWARE ENGINEER.

Have you ever attended an interview at any of the VirtusaPolaris Offices across the
Globe in the last 6 months? Yes/No (If yes, mention the details)

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HR Dept. - FORMS –Application Form.
 Declaration and Authorization

I understand that any employment by VirtusaPolaris India Private Limited or its affiliated
companies is conditioned upon positive responses from my references, bonding eligibility,
continued adherence to VirtusaPolaris India Private Limited policies and procedures, applicable
rules and regulations and job performance satisfactory at all times to VirtusaPolaris India Private
Limited.

I consent to take any pre or post-employment examinations as may be required by VirtusaPolaris

India Private Limited or its permitted agents, its representative, and release VirtusaPolaris India
Private Limited and its agents from any liability that may arise from such examination.

I authorize an inquiry to be made on the information contained on this application. Former

employers and officials of education institutes, named on this application are authorized to give
information about me and I release them from all liability for issuing such information.

I hereby attest and warrant that all my answers on this application as well as on all forms
completed in conjunction with my employment are true and accurate. I understand that my
misrepresentation of facts, failure to disclose information required on this application or material
change in my information provided which is not reported to Human Resources shall be cause for
dismissal regardless of when discovered by VirtusaPolaris India Private Limited

I understand, and authorize, that VirtusaPolaris may share my consumer report and/or
investigative report with third parties including auditors, government agencies, and clients as
necessary.

I hereby declare that the information given by me is true and the certificates or documents
submitted are genuine to the best of my knowledge.

Signed: ____K.SAI KRISHNA_________

Name in Block Capitals: __KUNAPUREDDY SAI KRISHNA

Date: ____15-05-2018_____________

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HR Dept. - FORMS –Application Form.