JOB APPLICATION FORM

Name: _________________________________

Confidential
PERSONAL INFORMATION
First Name Middle Name Surname

Mr./Ms./Mrs.
Paste
(Provided name and date of birth as per 10th
Certificate only) recent
Date of Birth Place of Birth (City / Village) Sex
colour
State Country Male Female
D D M M Y Y Y Y
photo
Marital Status
Father / Spouse Name PAN Number
Married Unmarried

Present Address :

City State Pin Code Phone

Contact
Number Mobile

Permanent Address:

City State Pin Code Phone

Contact
Number Mobile

E-Mail ID :
EDUCATION (Begin with the most recent qualification and end with Std. X)
Name of College/ School Name and Board/University Name and Dates Attended Full/ ID/ Roll Marks
Course / Address Address Part-time No. (% or
Degree From To CGPA)

Please explain gaps in education (if any)

Scholarships and prizes won during academic career:

Special training if any (Project work, Course assignments, Technical training, Professional training etc.,):

List any papers published by you/any honors/awards received during employment:

Membership of recognized professional bodies:

Have you been referred by a company employee? If yes

Name of Employee Employee Code Business Unit

Have you been referred by a Placement Agency? Yes / No If yes, name of the
agency
WORK EXPERIENCE (Ensure that you are descriptive wherever necessary – e.g. If Co. is closed, do mention it. Employee Code/
ID/ Number is mandatory. If your previous employer did not provide one, please mention and state reasons for the same.)
Name of Present / Last Employer Address and Landline Phone of Employer

Your Designation Division/ Department Employee Code

Notice Period
Employment Dates From: To:
Manager’s Name Manager’s Contact Number Manager’s Email ID Can a reference be taken now?
(Yes/ No)

Reason For Leaving: Was this Position Agency Details Are you willing to be posted anywhere? Yes / No
Permanent (if temporary or If no, your preferred location:
Temporary contractual)
Contractual
Duties and Responsibilities First salary drawn Last salary drawn

Fixed Salary (A): Variable Salary (B): Total Cost to Company:

Monthly Salary Break-up Annual Benefits Break-up Other benefits (Annual)
Basic Bonus Provident Fund
Dearness Allowance Ex-gratia Gratuity

HRA LTA Personal Accident Insurance

Car/Vehicle Allowance Medical Reimbursement Medical Benefit

All Others All Others Current CTC
Total Monthly Salary Total Annual Benefit Expected CTC

Do you have employee stock options? Yes / No If yes, current value:

PRIOR TO PRESENT / LAST EMPLOYMENT

Name of prior to present employer Address and Landline Phone of Employer

Your Designation Division/ Department Employee Code

Notice Period
Employment Dates From: To:
Manager’s Name Manager’s Contact Number Manager’s Email ID Can a reference be taken now?
(Yes/ No)

Reason For Leaving: Was this Position Agency Details Are you willing to be posted anywhere? Yes / No
Permanent (if temporary or If no, your preferred location:
Temporary contractual)
Contractual
Duties and Responsibilities First salary drawn Last salary drawn

PREVIOUS EMPLOYMENT DETAILS (Prior to the ones mentioned above)

Duration
Name of the Location Designation Designation Reason for Leaving
From To
Organization while Joining while Leaving (DD/MM/YY) (DD/MM/YY)

Please explain any gaps in employment:

REFERENCES Reference (1) Reference (2)
Name

Company
Current Designation

Nature of Relationship
Land line (with STD code) / Mobile

How many years you have known him / her?

ABOUT YOURSELF
Strengths – Area of developments –

Why do you want to join Dr. Reddy’s?

ADDITIONAL DETAILS

Type of employment you are interested? Full-time Part-time Others If others, please specify_______________________
Languages Known:
If other Nationality, Specify:
Nationality: Indian Others
Do you have work permit to work in India? Yes No
If Yes, Passport No.: Valid up to:
Do you hold a valid Passport? Yes No
If Yes, please detail
Have you been denied VISA to any country? Yes No
If Yes, please detail
Have you attended any selection process at Yes No
Dr. Reddy’s before?
If Yes, please detail
Do you have any relative employed Yes No
with Dr. Reddy’s?
If Yes, please detail
Have you suffered from any major illness Yes No
/surgery / accident in the last five years?
Have you ever been arrested, prosecuted Yes No If Yes, please detail
or convicted for any criminal offense,
other than minor traffic offenses?
At Dr. Reddy’s, we are proud to promote an open culture, encouraging people to be themselves and giving their ideas
a chance to flourish. To enable us to meet our commitment as a supportive employer, please let us know if you have Yes No
a disability If Yes, please detail:

Do you have any bond /commitment to another employer or organization that might affect your employment with us? Yes No
If yes, please detail:

Candidate Declaration
I hereby declare that my details on this form and on my resume or documents provided by me to Dr. Reddy’s are true and correct to the best
of my knowledge. I understand that Dr. Reddy’s may institute and conduct a background check to verify the information furnished by me. I
hereby authorize Dr. Reddy’s Laboratories Ltd. (or a third party agent appointed by the Company) to contact any former employers as
indicated above and carry out all background checks not restricted to education and employment as deemed appropriate through this
selection procedure. I authorize all persons who may have information relevant to the verification to make disclosures to Dr. Reddy’s or its
representatives/agents. I acknowledge and agree that providing any false information may result in a decision not to hire me or if hired, may
result in termination of my employment without any further enquiry. I understand that Dr. Reddy’s may notify and publish any information
provided by me that is found false. In addition, I understand and agree that Dr. Reddy’s has rights to seek any legal remedies including
indemnification and damages from me for any loss caused to Dr. Reddy’s as a result of any such false information.

Name : _______________________________________________ Signature: ______________________________

Place : ______________________________________________ _ Date : ______________________________

For official use only

Employee Code Head Quarter Date of Joining