EAF Employee Application Form - Revised

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Please affix your

ICA EDU SKILLS PVT LTD passport size photo


here

Employee Application Form (To be filed by applicant only)


Personal Information
Name*(As per Aadhar Card)

Father / Husband's Name Relation ###


Date of Birth*(dd/mm/yyyy) Gender*

Present Address* State City


Country Pin Code ###

Permanent Address

Residence Contact no Mobile No* Nationality ###


Email ID ( Personal )* Mother Tongue Religion ###
Marital Status* Marriage Date Category ###

Bank & Identity Details (Attach Proof)


Bank A/c No* Pan Number*
Bank IFSC Code* Aadhar Number*
Bank Branch Name Passport Number, If any

Family Details*
Sr No Name Date of Birth Gender Relationship Occupation
1
2
3
4
5

Medical Condition
Blood Group*
Ailments ( Heart condition, BP etc )
Allergies (Drug etc )

Emergency Contact Details*


Sr No Contact Person Name Relation Landline No Mobile No
1
2

Educational Qualification*
Sr No Degree/Diploma/Certificate Institute/University From To Percentage
1
2
3
4
5

Previous Employment Details (Last Organisation)


Employee Id UAN Number
Date Of Joining* ESIC A/c No
Designation* Current CTC

Employment History

Date of Last Working Reason for


Sr No Organisation Name Employment Type Designation Joining Date CTC Reporting Manager & Contact No
leaving
(DD/MM/YYYY) (DD/MM/YYYY)

Total Experience 0 Year's / Month's

Professional References - 2 Nos *


Sr No Name Contact No Email ID Designation Organisation
1
2

Personal References - 2 Nos *


Sr No Name Contact No Email ID Relation Current Occupation
1
2

Application Source Information


Application Source*
Agency / Portal Details Name of Employee Referral Employee ID / Department
(Select From Drop Down)

I hereby affirm that the aforementioned information given by me is true and correct and that I have not held back any information. Any information given here is found to be false, I shall be liable for dismissal.

* Mandatory
** In case any changes in personal information should be intimated to HR department within 48 hrs.
Date
Place
Signature

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