Candidate ID: 61090632

FOR OFFICE
USE ONLY

Please affix

Status : ..............................

your Passport Size

INFOSYS LIMITED

TC / Unit : ..........................

Photograph here.

Electronics City, Hosur Road,Bangalore - 560 100,India.

Tel.: (080) 28520261-270. Fax: (080) 28520362.

Role : .................................

APPLICATION FOR FRESHERS

NAME OF THE COLLEGE : .........................................................................................................................................
NIT Patna
CITY : .................................................
Patna
NAME IN FULL
(In Block Letters)

ADITYA
...........................................................

.............................................................

PERSONAL DETAILS

(First Name)

KUMAR
...........................................................

(Middle Name)

ADDRESS FOR COMMUNICATION :

(Surname)

DATE OF BIRTH ( dd / mm / yyyy ):

C/o
Abhay Karna Mithila Path, Phulwarisharif
...........................................................................................................

19/10/1990
__
___ _______

...........................................................................................................
...........................................................................................................
City : Patna
......................................

State :

Country : .................................
India

Pin Code : 801505

................................

Bihar
..................................

Preferred Contact Number : ............................................................

8804223327
Alternate Contact Number : ............................................................
8521289622
EDUCATION LEVEL

X STD
Secondary School
Leaving Cert.

GENDER (Please Tick '' )

Male

Female

CITIZENSHIP : ...................................................................................
Indian
DO YOU HAVE A PASSPORT?
E-mail :

Yes

No

[email protected]
.............................................................................................

XII STD /
EQUIV.
Others

GRADUATION

POST
GRADUATION

DIPLOMA /
OTHERS

Bachelor Of Technology

Name of the Qualificatiion Awarded

Central Board of
Central Board of
All IndiaCouncil for
Secondary Education Secondary Education Technical Education

Name of the Board / University

Kendriya Vidyalaya

Kendriya Vidyalaya

NIT Patna

Bihar

Bihar

Bihar

General

PCM

Electronics Engineering

EDUCATION

Name of the School / College

State

Branch / Stream / Area of Specialization

Simple Average Percentage / CGPA / Grade *

Month and Year of Passing

94%

87.2

8.27

05 / 2007

05 / 2009

06 / 2014

* ALL PERCENTAGES / CGPA SHOULD BE SIMPLE AVERAGE FOR ALL YOUR SUBJECTS / SEMESTERS / YEARS, INCLUDING
ELECTIVES, OPTIONAL SUBJECTS, ADDITIONAL SUBJECTS, PRACTICAL SUBJECTS AND LANGUAGES.
ANY ACTIVE BACKLOGS ?

YES

NA
Number of active backlogs: .....................................

NO

......................................................................................................................................
OneYears.
Year gap Reason:
from 2009Preparation
to 2010 to improve IIT-JEE and AIEEE rank as compared to the ranks obtained
GAPS IN EDUCATION (IF ANY): ........
in 2009
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PLEASE WRITE 'NA' IF NOT APPLICABLE.

Specify clearly in case of part time / contract work experience.

Notice period required.......................................... (in weeks)

WORK EXPERIENCE

PERIOD( MM / YYYY )
GROSS
SALARY

DESIGNATION

ORGANIZATION

FROM

TO

DURATION

HAVE YOU UNDERGONE ANY SELECTION PROCESS WITH INFOSYS OR INFOSYS GROUP
COMPANIES (LIKE INFOSYS BPO, ETC.) PREVIOUSLY ?
IF YES, HAVE YOU

INFOSYS

REASON FOR
SEPARATION

YES

NO

OTHER INFOSYS GROUP COMPANIES

RELEVANT DATES

- TAKEN ANY TEST ?

NO

LEGAL
OBLIGATIONS.
IF ANY ( Y / N )

RELEVANT DATES

YES

NA

YES

NA

................................. NO

YES

NA

YES

NA
NO
.................................

YES

NA

YES

NA

YES

NA

NA

YES

................................. NO

NO
NO

.................................

- BEEN SELECTED FOR INTERVIEW ?

.................................

- BEEN MADE AN OFFER ?

- JOINED ?
MISCELLANEOUS

NO

................................. NO

ARE YOU EMPLOYED AS : 1. A DIRECTOR IN ANY OTHER COMPANY ?

2. A PARTNER IN ANY FIRM ?

YES

NO

YES

NO

.................................
.................................

.......................................................................................................................................................................
IF YES, PLEASE PROVIDE DETAILS NA

ARE YOU CURRENTLY EMPLOYED WITH ANY OF THE INFOSYS GROUP COMPANIES ?
IF YES, INFOSYS BPO

OTHERS

YES

NO

NA
Please Specify ...........................................................................................................................

Have you at any time been convicted by a court of India for any criminal offence and sentenced to imprisonment, or are any criminal
proceedings pending against you before a court in India, or has an order prohibiting your departure from India, been issued by a court ?
YES

NO

If yes, please give details of the same NA

.....................................................................................................................................................................

DECLARATION

I certify that the academic marks / CGPA are simple average for all subjects / semesters / years including electives,optional subjects,additional
subjects, practicals and languages.
I authorize investigation of all statements made in this application and my supporting documents. I authorize Infosys to secure information
about my experience from former employers, educational institutions, government agencies or any references I have provided, and for those
parties to provide information concerning my qualifications for employment and I hereby release all parties from any liability arising from such
investigation.
I understand that if I am employed, any false statement, misrepresentation, or omission of facts on this application or on any supporting
documents, regardless of when discovered to be false, may result in my immediate dismissal. The company will have the right to withdraw my
letter of appointment or to terminate my training / subsequent appointment at any time without notice or compensation.
My signature below certifies that I have read, understood, and agree to the foregoing and to the best of my knowledge and belief, the
information on the application form is true and correct.

FOR OFFICE
USE ONLY

Date : ......................................

Place : .................................................

Signature: ...............................................................

Date of Test / Interview :.............................................. Date of Interview (if differ from Date of Test) :..............................................

Result :

Selected

Hold

Rejected

(Please '' )

Name : .......................................................................................... Emp. No. : ............................ Signature : ....................................................

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