APPLICATION FORM

Please fill in the details with utmost attention, as these shall be verified by Cognizant Technology
Solutions and/ or by its authorized representatives. Please Affix Your
Passport Size
Photograph
All details are compulsory.

PERSONAL DETAILS
Name of Applicant: Surname Middle First

Home Phone: STD Code Number

Date of Birth (dd/mm/yy): Marital Status:
Office Phone: STD Code Number
Place of Birth: Nationality:

Sex: Passport No.: Mobile:

E-mail id:

RESIDENTIAL ADDRESSES
CURRENT ADDRESS:

City: State: Pin Code: Phone No.:

Duration of Stay: From (mm/yy) To (mm/yy)
Nature of location: Rented Own Other (Specify)

PERMANENT ADDRESS:

City: State: Pin Code: Phone No.:

Duration of Stay: From (mm/yy) To (mm/yy)
Nature of location: Rented Own Other (Specify)

LONGEST STAY ADDRESS IN THE LAST SEVEN YEARS:

City: State: Pin Code: Phone No.:

Duration of Stay: From (mm/yy) To (mm/yy)
Nature of location: Rented Own Other (Specify)

All details are compulsory Strictly Private &

Confidential
 FAMILY DETAILS
RELATION NAME AGE EDUCATION OCCUPATION DEPENDANT (Y/N)

FATHER

MOTHER

SPOUSE

CHILDREN

BROTHERS

SISTERS

EDUCATION DETAILS
DATES
ATTENDED ROLL
NAME & NAME & ADDRESS OF COURSE MARKS (%) YEAR NUMBER/
ADDRESS OF BOARD / UNIVERSITY ATTENDED CGPA OF REGISTRATIO
QUALIFICATION SCHOOL / TO WHICH THE SCHOOL / (MORNING/ YEAR
& ENRO N NUMBER/
COLLEGE/ COLLEGE / INSTITUTE EVENING/ PASSED
CORRESPONDENCE) CLASS LMEN EXAM SEAT
INSTITUTE IS AFFILIATED TO (MM/YY)
T NUMBER
(MM/YY)

SSC
(X TH GRADE)

HSC
(XII TH GRADE)

GRADUATION

DEGREE:

DISCIPLINE:

POST
GRADUATION

DEGREE:

DISCIPLINE:

ANY OTHER

All details are compulsory Strictly Private &

Confidential
 REASONS FOR BREAKS IN EDUCATION:
______________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

SKILL SET: (MENTION SKILLS YOU ARE APPLYING FOR):

SKILLS TOTAL EXPERIENCE * SELF RATING
(IN MONTHS)

* (Please follow this Rating Scale for each skill: -4 - Excellent, 3 - Good, 2 - Average, 1 – Beginner)

WILLINGNESS TO WORK ANYWHERE IN INDIA: YES NO

WILLINGNESS TO WORK ANYWHERE OUT OF INDIA: YES NO

PRIOR INTERNATIONAL EXPERIENCE: YES NO

DURATION OF ONSITE ASSIGNMENTS ABROAD IN MONTHS: _________________

PASSPORT DETAILS:
AVAILABILITY YES NO
IF YES, PASSPORT NO:

VISAS STAMPED
(LIST OF COUNTRIES):

VISA REJECTION HISTORY:

REASONS FOR REJECTION:

All details are compulsory Strictly Private &

Confidential
 EMPLOYMENT RECORD: Starting with your present or most recent employer, please list all employments during the last five years. Include
military service, temporary, part-time and summer work. When listing consulting or temporary assignments, under “Employer”, state the name of the
consulting or temporary agency that placed you at the client site. Complete and accurate dates (month/year) must be provided.
For compensation sections, specify currency and basis for salary (i.e. monthly or yearly).
CURRENT EMPLOYER: Employee Id: From (mm/yy): To (mm/yy):

Street Address: Employer’s Fax No.:

Phone No.:
City: State: Country: Postal Code:

Job Title: Description of Duties:

Employment Status: (Please check the relevant box) Supervisor’s Details:

Name:
Full Time
Contract /Through Outsourcing Agency Title:
Phone No.:
Outsourcing Agency Details: E-mail id:
Name: (Preferably official)
Address: HR Manager’s Details:
Tel No.: Name:
Reason for leaving: Phone No.:
E-mail id:
(Preferably official)

EMPLOYER 1: Employee Id: From (mm/yy): To (mm/yy):

Street Address: Employer’s Fax No.:

Phone No.:
City: State: Country: Postal Code:

Job Title: Description of Duties:

Employment Status: (Please check the relevant box) Supervisor’s Details:

Name:
Full Time
Contract /Through Outsourcing Agency Title:
Phone No.:
Outsourcing Agency Details: E-mail id:
Name: (Preferably official)
Address: HR Manager’s Details:
Tel No.: Name:
Reason for leaving: Phone No.:
E-mail id:
(Preferably official)

All details are compulsory Strictly Private &

Confidential
 EMPLOYMENT RECORD CONTINUED:
EMPLOYER 2: Employee Id: From (mm/yy): To (mm/yy):

Street Address: Employer’s Fax No.:

Phone No.:
City: State: Country: Postal Code:

Job Title: Description of Duties:

Employment Status: (Please check the relevant box) Supervisor’s Details:

Name:
Full Time
Contract /Through Outsourcing Agency Title:
Phone No.:
Outsourcing Agency Details: E-mail id:
Name: (Preferably official)
Address: HR Manager’s Details:
Tel No.: Name:
Reason for leaving: Phone No.:
E-mail id:
(Preferably official)

EMPLOYER 3: Employee Id: From (mm/yy): To (mm/yy):

Street Address: Employer’s Fax No.:

Phone No.:
City: State: Country: Postal Code:

Job Title: Description of Duties:

Employment Status: (Please check the relevant box) Supervisor’s Details:

Name:
Full Time
Contract /Through Outsourcing Agency Title:
Phone No.:
Outsourcing Agency Details: E-mail id:
Name: (Preferably official)
Address: HR Manager’s Details:
Tel No.: Name:
Reason for leaving: Phone No.:
E-mail id:
(Preferably official)

All details are compulsory Strictly Private &

Confidential
 EMPLOYMENT RECORD CONTINUED:
EMPLOYER 4: Employee Id: From (mm/yy): To (mm/yy):

Street Address: Employer’s Fax No.:

Phone No.:
City: State: Country: Postal Code:

Job Title: Description of Duties:

Employment Status: (Please check the relevant box) Supervisor’s Details:

Name:
Full Time
Contract /Through Outsourcing Agency Title:
Phone No.:
Outsourcing Agency Details: E-mail id:
Name: (Preferably official)
Address: HR Manager’s Details:
Tel No.: Name:
Reason for leaving: Phone No.:
E-mail id:
(Preferably official)

Note: Incase of more than three employer’s during the last five years of employment, kindly attach an additional
employment sheet and fill in the details.

REASONS FOR BREAKS IN EMPLOYMENT HISTORY: ______________________________________________

____________________________________________________________________________________________

SIGNIFICANT ACHIEVEMENTS (FROM PREVIOUS EMPLOYMENTS):

____________________________________________________________________________________________
____________________________________________________________________________________________

EXPECTATIONS FROM COGNIZANT (ROLE/RESPONSIBILITY):

____________________________________________________________________________________________
____________________________________________________________________________________________

YOUR KEY STRENGTHS/WEAKNESS:

____________________________________________________________________________________________
____________________________________________________________________________________________

CURRENT SALARY DETAILS:

BASIC: OTHER ALLOWANCES: TOTAL ANNUAL PACKAGE:

HRA: MEDICAL:
EXPECTED SALARY AT COGNIZANT (INR):
PF: CONVEYANCE:

LTA: TOTAL MONTHLY:

All details are compulsory Strictly Private &

Confidential
 PROFESSIONAL REFERENCES
PARTICULARS REFERENCE 1 REFERENCE 2
NAME
DESIGNATION
COMPANY
LANDLINE
MOBILE
E- MAIL
ADDRESS

YOUR SHORT TERM AND LONG-TERM GOALS:

___________________________________________________________________________________________
___________________________________________________________________________________________

ANY OTHER DETAILS YOU WOULD LIKE TO MENTION (CERTIFICATIONS/PRESENTATIONS MADE ETC,)
___________________________________________________________________________________________
___________________________________________________________________________________________

AFFIDAVIT
I certify that the statements made in this application are valid and complete to the best of my knowledge. I understand that Cognizant
Technology Solutions is an at will employer, false or misleading information may result in termination of employment, with or without
cause and with or without notice.

I understand that Cognizant Technology Solutions may request a credit and/or background check from a credit reporting agency or related
service. I understand that I have a right to make a written request within a reasonable time for the disclosure of the name and address of the
credit-reporting agency so that I may obtain a complete disclosure of the nature and scope of any investigation.

I understand that the records will be used for employment purposes only and will not be given to unauthorized persons.

I authorize Cognizant Technology Solutions, and/or its agents to conduct a reference check so that a hiring decision may be made. In the
event that Cognizant Technology Solutions is unable to verify any reference stated in this application, it is my responsibility to furnish the
necessary documentation.

I understand that this application or subsequent employment does not create a contract of employment nor guarantee employment for any
definite period of time.

I have read, understood, and by my signature consent to these statements.

SIGNATURE:
DATE:
NAME (IN BLOCK LETTERS):

DOCUMENTS REQUIRED (COMPULSORY)

Completed & Signed Application Form Two Passport Size Photographs
Copy of Relevant Education Certificates Current Address Proof (if stay at current address > 6 months) else
Longest Stay Address Proof.
Copy of all past Employment Relieving Letters / Salary Please note: Your name should be mentioned on the address proof.
Slips Accepted address proofs: MTNL Bill / Electricity Bill/ Copy of Rent
Agreement/ Passport/ Voter Id/ Driving License.

All details are compulsory Strictly Private &

Confidential