BL Application Blank Format-2003

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POST APPLIED FOR: _____________________________________________________________________ [Name and Address should be in Block Letters] Name [Last]: [First]: [Middle]: Date

of Age (as on date of notification in Years & Months): birth [Day]/ [Month]/ [Year]: Spouses Name [in case married candidate]: Communication Address:

Telephone No. with STD Code [Residence] Sex Marital Status

Telephone No. with STD Code [Office] Nationality

Mobile

E-Mail

Religion

Home Town and State

Whether SC / ST / OBC (Non-Creamy Layer)/ PWD (OH/HH/VH)/ Ex-Servicemen/ General: If SC / ST / OBC, please specify Sub Caste: Educational / Professional Qualification [Starting from School Final [ Class X ] onwards]* Examination/ Course University / Board Duration Year of % of Stream/ Specialization / Institute (in Years) Passing Marks (Location)

Work Experience [Starting from present organization]* Name of Company/ Position Held Full Durati Fro Employer (F) / on (in m Part Years) (P) Time

To

Major Responsibilities

Details of Present Emolument: Present Monthly Gross** Pay Expected Monthly Gross Pay Notice period required, if any Languages Known: Speak Read Write Whether any relative employed in Balmer Lawrie & Co. Ltd.: Name

Present CTC# in Rs. Lacks Expected CTC in Rs. Lacks Is Expected Salary Negotiable?

Yes/ No Designatio n

If Yes please provide following details Department / Division Location

Declaration: I certify that the foregoing information is correct and complete to the best of my knowledge and belief. Date : Place: Signature :
Note:
All details requested are mandatory, where information not applicable mention NA. Company may reject incomplete application. Wherever CGPA/OGPA or letter grade in a Degree is awarded, equivalent percentage of marks should be indicated in the application as per norms adopted by University/Institutes

*- Attach extra sheet if space is insufficient. **- Monthly Gross: Basic Salary+ DA+ Grade Pay+ HRA+ Allowances paid through Monthly Salary # - CTC (Annual): Annual Gross + Annual Cost of (Benefits in Kind + Retirement Benefits) + Variable Pay + Work Related Reimbursements

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