Private & Confidential

TECHNIP INDIA LIMITED

Corporate Office:
Technip India Ltd., B1 - 701 / 701 A, Boomerang, Chandivali Farm Road, Andheri (E), Mumbai - 400072

Regd. Office & Works:

B-22, Okhla Industrial Area, Phase-I
New Delhi- 110 020
Tel: +91-(0)11-26813664, 26817632, 26819057, 26819407
Affix
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APPLICATION FOR EMPLOYMENT ogra
To be filled in candidate’s own hand ph
here
Post Applied for ___________________________________ Location _____________________
Reference No. ____________________________________ Dated _______________________

1. Name (in block letters)

First Name Middle Name Last Name

2. Father’s/Husband’s name 3. Occupation

4. Date of Birth 5. Place of Birth 6. Blood Group 7. PAN

8. a) Present Address: Tel:

Mobile:
Email:

b) Permanent Address: Tel:

Mobile:
Email:

9. Name(s), address(es) and phone number(s) of nearest person(s) to notify in case of emergency:
Name Address Tel

10. a) Marital status: Married Single

b) If Married, Date of Marriage and No. of Children:

11. Nationality Passport No. Valid up to Country

12. a) Have you ever been medically examined and if so, when and with what results?

b) Physical defects if any:

c) General: Height Weight Eyesight (use spectacles) Yes/No

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13. Qualifications
a) Academic (in chronological order and Attach copy of testimonials)
Division
Year of % marks
Name of School / College Examination Passed Main Subjects
Passing obtained
or Class

b) Professional (Attach copy of certificate or degree)

Year of Division % marks Rank
Institute Examination Passed
Passing or Class obtained if any

c) Membership of Professional Institutes:

Institute Status Membership No.

14. Fields of Specialisation:

Specialised Course/Programmes attended:
Course Conducted by Duration

15. Are you pursuing any formal Studies/Courses? Yes No

If yes, please elaborate

16. Languages Known:

Can Speak Can Read Can Write

17. Foreign Visits: Country Duration Purpose

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 18. Experience (in chronological order):
(Attach testimonials where available and use extra sheets, if required)
Duration of service Total
Designation/ Type of Job Responsibility
Organization and address From To emoluments
Capacity Industries / business in each capacity
mm-yy mm-yy at leaving

19. a) Break-Up of Present Emoluments:

Component Amount Component Amount
1 6
2 7
3 8
4 9
5 10

Benefits/Perks:
Component Amount Component Amount
1 6
2 7
3 8
4 9
5 10

b) Expected Emoluments:

20. Outline your Reporting Relationships (i.e. whom you are responsible and who are responsible to you) through a suitable
organisation chart. Underline your position in the chart.

21. If selected, minimum period required to join:

22. Are you a member of Provident Fund Scheme Employee Pension Scheme E.S.I. Scheme
Yes No Yes No Yes No

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23. a) Have you ever worked in any of the Technip companies before? If yes, give details:

b) Have you applied earlier for any post in the Company / Group Company? If yes, give details.

24. a) If any relative of yours employed/was employed in the Company? If so, give details.

b) Names and designations of persons known to you (other than relations) in this Company.

25. Have you ever been convicted by any Court? If so, give details.

26. References (other than relatives): 1.

(Name, Designation, Address)
2.
3.

27. Any other particulars that you wish to state:

I hereby declare that the above particulars are true and correct to the best of my knowledge and nothing has been concealed. If any
of the above statements are found to be false or incorrect, I will be liable to be dismissed summarily.

Date: Signature of the Applicant

FOR OFFICE USE ONLY

Recommended/Not recommended for appointment

If appointed: (Nature of appointment): Regular/Trainee

Temporary/Contract (specify period)

Designation/Job Group_____________________ Department______________________ Location__________________

Starting Salary + Allowances: __________________________________________ Total Rs. __________________P.M.

Joining Date: __________________________ Probation/Training Period: ________________

Remarks:

____________________________
Signature of the Interview Panel

Appointment Approved by: ______________________________

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