GENERAL OPTICS (ASIA) LIMITED
APPLICATION FOR EMPLOYMENT
NB
1. This application must be handwritten by the applicant.
2. All columns must be answered. Blank space shouuld not be
left
3. Additional sheets to be used wherever space provided is
not sufficient
1. PERSONAL DATA
Name
(ALL IN CAPITAL LETTERS)
1.1 PRESENT ADDRESS
PERMANENT ADDRESS
Pincode
Pincode
E-mail
Contact Nr
Mobile Nr
1.2 DATE OF BIRTH
(DD/MM/ YYYY)
1.5 HEIGHT (Cms)
Tick appropriate box as applicable
P
1.3 Sex
1.4 Status
Male
Female
Single Married Divorced
Age Yrs
1.6 WEIGHT (KG)
1.7 VISION
1.8 BLOOD GROUP
2. DEPENDENTS (Spouse & Children)
2.1 In case of Emergency notify
Name/ Relationship Age
Educational Occupation Name
Qualification
Relationship
Address
Phone
Nr
3. EDUCATION ( (School/ Polytechnic/ College etc) - Also mention Additional Qualifications if any)
Name & Address of the School/ Polytechnic/
Dates Attended
Degree/ Diploma Class/ Distinction
College studied
Obtained
From
To
4. EMPLOYMENT (Commencing from recent employment)
Name & Address of the company
Position held last
Period
From
5. FAMILY PARTICULARS (Father, Mother, Brothers, Sisters)
Name
Relationship Occupation Educational
Qualification
6. REFERENCES (Not Relatives/ Friends)
Name
Occupation
Address
7. PHYSICAL STATUS (Tick appropriate box as applicable)
7.1 Present Physical Excellent
Good
condition
To
Salary p.m
Basic + Allowances
Employer if employed
Contact number
Fair
Poor
7.2 Ever been
hospitalised
Yes (If yes why &
where)
No
7.2 Physical Defects/ Disabilities
Yes (If yes
details)
No
8. ANY OTHER DETAILS
Yes (If yes
details)
No
8.1 Languages known
Language
Tick appropriate
Read
Write
P
Speak
Mother Tongue
Other Languages
English
Hindi
8. OTHER DETAILS
Yes (If yes details)
No
I hereby certify that all above answers/ information given by me are true and correct. No attempt has been made to
conceal or withold pertinent information. If employed on the basis of this appliication, I will comply with all Safety Rules,
Rules of conduct and all other Rules and Regulations of the Company as they exist from time to time.
I also authorise the company to investigate any/ all statements at any time with no liability, arising therefrom.
If, upon investigation anything contained in this application is found to be untrue I understand, I will be subject to
dismissal at any time during the period of my employment.
Date (DD/MM/YYYY)
Signature of Applicant