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Gujarat Mineral Research & Industrial Consultancy
SocietyKhanij Bhavan , 132 Ft. Ring Road, University ground,
Vastrapur , Ahmedabad - 380052
Ph 079-27913200EMail: [email protected]
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EMPLOYMENT APPLICATION FORM
POST APPLIED FOR:
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First Name
Middle Name
Last Name
Birth Date
Place of Birth
Nationality
Category
Gender:
Native Place:
Marital Status:
DDGeneral SEBC
Father! Husband's Name:
DDSC ST
Father! Husband's Occupation:
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Personal Account
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Permanent Address:
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Current Address:
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--------Contact Number: (M) (R) (0) _
E-mail Address:
Present Salary (P.M.): Expected Salary (P.M.):Howsooncanyoujoin?
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Have you been interviewed earlier by us? If yes, give
particulars:
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Academic Record (Starting from SSCor equivalent), also submit
attested certificate.
Examination Institute Board/ Year of %/ CGPA MajorUniversity
passing / Grade Subjects
Details of Effective date of obtaining statutory Certificate
(For Statutory Post).
Have you undergone any other Training? If yes, give details.
Mention your research! publication, if any.
Mention your membership of Association indicating your role.
Extra Curricular Activities:
Language Proficiencv:
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Exoerience Chronolozv alonz with certificates· .Name of the
Designation Period Last total
Organization From To Total Salary P.M
Why do you wish to change?
References (Other than your relative):
Address & ContactSr. No. Name. Occupation No.
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Any other ability/Information in support of your application
I declare that a" the details given in this form are correct and
complete to the best ofmy knowledge and understanding and hereby
agree that any misrepresentationtherein may cause rejection of my
application or termination of my servicewithout notice or
compensation thereafter.
I confess that I am not involved in any Criminal matter Or
Police inquiry.
I agree that my employment will be subject to transfer to any
project by theCorporation.
Date: _
Place: -------(Signature of Applicant)
