Position Applied for: EXPORT IMPORT DOCUMENTATION Date:22/11/2024

A) Personal Details

Person to meet:

1. Full Name: MADINA NISHMA

____________________________________________________________________________

Address (Present): 1-65a PEDDA SRI 2. Address (Permanent): 1-65a PEDDA SRI
RAMPURAM(VILLAGE)KATTIVARAM(POST) RAMPURAM(VILLAGE)KATTIVARAM(POST)
SRIKAKULAM(DIST)ANDHRA PRADESH 532290 SRIKAKULAM(DIST)ANDHRA PRADESH 532290

3. Other Details

Date of Birth: 12-08-2002

Age: 22

Place of Birth: SOMPETA

Mobile No: 7729005658

Email Address: [email protected]

Marital Status: NO

Nationality: INDIAN

Religion: HINDU

Passport No: -

4. Emergency Contact Information

Name: MADINA RAVI PRASAD RAO

Contact No: 8374887767
Relationship: FATHER

5. Language (Please Tick () wherever applicable)

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 Language Read Write Speak
a)ENGLISH √ √ √
b) TELUGU √ √ √
c) HINDI √ √
d)

6. Have you suffered from any illness during the past five yrs. which involved in any absence from duty for a
continuous period of over two weeks? Y/N
if yes, please give details NO

7.Do you have any permanent disability? Y/N

if Yes, please give details about the type of disability NO

8. Are you related to any past or present employee of the Company or any other associated company? Y / N
if yes, please fill below details NO

Name:
Relationship:
Company Name:
9.Were you previously interviewed by any of the JM Baxi Group Company Y/N
If yes, please fill below details
Interviewed by:
Date: Place:
Post:

10. Have you previously been employed with us? Y/N

If yes, please fill below details: NO
Company: Designation:
Date of Leaving: Date of Joining
Reason for Leaving
Reporting Manager Name:

B) Family Details

Relation Name Ag Education Employment

e
Father MADINA RAVI PRASAD RAO 50 SSC FARMER

Mother MADINA SUNITA 45 SSC HOME MAKER

Sibling MADINA SUSHMA 24 B TECH TCS

Spouse

Children

Degree Name of the Institute Year Major Subjects

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 Name of the From To % or CGPA
Qualification JMJ ENGLISH MEDIUM HIGH SCHOOL
Rank
X SSC 2016 2017 NA 9.3
BiPC SRI CHAITANYA Jr COLLEGE 2017 2019 BIOLOGY 9.95
XII
GAYATRI COLLEGE OF SCIENCE
Graduation BSC(CBZ) 2019 2022 ZOOLOGY 9.3
&MANAGEMENT
GAYATRI VIDYA PARISHAD COLLEGE FOR
Post-Graduation MBA 2022 2024 LOGISTICS& 8.16
DEGREE & PG COURSES

Others SUPPLY CHAIN

C) Education Details

1.In Case of any current backlog / Arrear in the academic career please mention: NO
Degree: Subject:
Exam due on which date:
2. Significant Academic Achievements: Got an appreciation certificate in department of youth services

3. Any other Certifications/Trainings & Special Course Attended: Got a completion certificate at Sarada Metals and
Alloys LTD

4. Extra-Curricular Activities/Hobbies: Badminton, Integrated farming, Cooking

Name of the Organization

(Start with the current/Last Location Duration
co.) Last position held CTC PA Reason for leaving
From
To

KARUR VYSYA BANK Till Branch sales and 3LPA For better opportunity and
service executive career growth in logistics
Srikakulam 23/9/24

D) Work Experience

1.Any Significant Career highlights

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 2. Please share your vision/future aspirations for your career
To become a more responsible and knowledgeable personality in the domain I work and achieve a good position in
the organization

3.Additional Information if any

4. Current & Expected CTC (Please also fill in the breakup of the CTC in the sheet attached along with the form)

Current CTC Expected CTC

Per Annum 3,00,000 According to the negotiations
Gross per Month 25,320.96
Net Take Home 24,003.96

5.Notice Period :

Current Notice Period: _________ _______1 month____________________

Is your Notice Period Negotiable (Y/N): _____NO____ _____________

E) References

List two references, other than relatives (Preferably your immediate superiors)

Name Designation Organization Telephone/ Mobile/ Email

Veeranjaneyalu Assistant manager Karur Vysya 9347433147
Bank

Ravi Relationship Karur Vysya 8500271318

manager Bank

Please draw below the organization chart of your present company, clearly indicating your level and direct
reportees: Page | 4
BRANCH HEAD
 Declaration

I hereby certify that the above information provided is true and to the best of my knowledge.

Any false or misleading information provided on this form or any other document may result in the employment being
terminated

22

In the event of employment by the company, I agree to abide by all rules and regulations and standing orders of the
Company in force or which may be amended, altered or extended

from time to time.

I hereby permit the company to carry out background verification on the Information provided in the form. In case of
any discrepancy found after joining, the company can initiate actions as per its policy

M. Nishma

Date: 22/11/24 Signature of applicant

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