Personal History Form (Confidential)

 After completing please return this form to us as quickly as you can but
not later than the date of interview.
 Your selection will largely depend upon the honesty and completeness
of the information you give, which will be held strictly confidential.
 Source : Job Portal/Consultant/Employee Referral/ Campus/Walk-In/Ads
(Tick the appropriate one from the above)
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 To be filled by HR:
Consultant: _________________________________________________________________________________
Employee Referral: Employee Name____________________________________ Emp. Code__________
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POSITION APPLIED: _______________________________________________________________________
Personal Information
1 Name: Date of birth :

2 Present address :

Residence tel :(specify STD code) Tel No :

3 Present Official address

Office tel.(specify STD code) Tel No :

4 Email address Mobile no

5 Give two (references (not relations) whom we can refer for verification indicating their positions and
organization they work for)
1 Tel. No., Email ID :

2 Tel. No., Email ID:

6 Please indicate your current Total CTC (Cost to Company) p.a. Rs. ______________p.a.

7 Please indicate your expected CTC p.a.

8 Please indicate your notice period : ___________________________
9 Educational qualifications: (starting from S.S.C)

1
Sr. Exam passed (Degree, Year of passing School/ Board/ Class/ Main subjects
No. Diploma/ Certificate) college university marks
obtained

10 Details of work experience:

Please record your experience, details in chronological order starting from present employment.
Sl. Date Name of Employer Last Annual Gross Reasons for
No. Designation Salary leaving
held (CTC P.A)
From To
1

2
11. Organisation Chart
Kindly draw the reporting relationship above and below you:

DECLARATION:
PRIOR ASSOCIATION
Have you ever applied or been interviewed for a job in this Company or in any of the AEL Group or
Associate Companies. YES / NO
If Yes, please give details:

Position: Outcome:

Have you ever worked in this Company or in any of the AEL GROUP or Associate Companies before?
YES/NO
If Yes, please give details:

Indicate acquaintances and relatives (in the widest sense) associated with the Group and Associate
Companies.
Name Relationship Particulars Company
(i.e. Position etc.)

3
Service / Secrecy Agreement & Declaration

I hereby declare that I have signed / not signed any service / secrecy agreement with my present
employer. Salient features of the service / secrecy if signed, are as follows:

Date: Signature
I hereby declare that the foregoing statements are true to the best of my knowledge and I understand that
it will form the basis of contract of employment if I am employed by the company. If at a future date, it is
found that any of the information herein is false or incorrect in any material respect, the company will have
the right to terminate my service without any notice or salary in lieu thereof.

Date: Signature