ARKA EDUCATIONAL AND CULTURAL TRUST

NEW EMPLOYMENT FORM

Date:

1. PERSONAL INFORMATION

Full Name:
First Middle Last

Current Address:

Door No. / House No Apartment Name Street Address

City State PIN Code

Permanent Address:

Door No. / House No Apartment Name Street Address

City State PIN Code

Date of Birth: Age: Blood Group:

Gender: Male Female Others Marital Status: Single Married Others

E-Mail: Phone No.1: Phone No.2:

Religion: Caste: Nationality:

Father’s Name: Mother’s Name:

Spouse Name: No. Of Children:

Name of Emergency Contact Person:

Relationship with Emergency Contact Person:

Phone Number of Emergency Contact Person:

Languages Known:

Page 1
 2. EMPLOYMENT DETAILS

Position Applied For:

How Did You Get To Know About This Vacancy?

☐ Employee Referral ☐ Walk-in ☐ School Website ☐ Others (Please specify)

GENERAL QUESTIONS:

1) Do You Have Any Relatives/Friends Working in this organization? ☐ Yes ☐ No

(If yes, give Name and Details)

2) Have you ever been convicted of a crime? ☐ Yes ☐ No

(If yes, Please Explain)

3) Are you currently employed? ☐ Yes ☐ No

4) Are you willing to relocate? ☐ Yes ☐ No

5) If selected how much time would you require to join?

6) Mention any course or studies that you are pursuing at present. Will you need any
leave on this account?

7) Your Strengths:

8) List Your Areas Of Highest Proficiency, Special Skills Or Other Interests That May
Contribute To Your Abilities

9) If selected, accommodation provided by the organization or not?

Page 2
 3. EDUCATION

Qualification Subject/Specialization Board/Institution/University Location Year of Percentage/CGPA

X Standard

XII
Standard

Graduation
Post-
Graduatio
n

B. Ed.
/D.Ed.

M.Ed.
Others
(ifany)

4. NOMINEE DETAILS

Name of the nominee:

Relationship of the employee with the nominee:

Proof of relationship with the nominee:

Phone Number of the nominee:

Bank account details of the nominee:

a) Bank Account Number: b) Name of the Bank:

c) Bank Branch: d) IFSC Code:

Proof of Bank Account Details of the Nominee Who Should Be An Individual Account Holder
(Scanned Copy of Bank Passbook / Cancelled Cheque):

5. DOCUMENTATION DETAILS

i) Aadhaar Number: ii) PAN Number:

iii) Bank Name: iv) Bank Branch:

v) Bank Account Number: vi) IFSC Code:

Page 3
 6. PREVIOUS EMPLOYMENT DETAILS
Total Years of Experience:

Kindly Mention Your Last 3 Employment Details

PARTICULARS PREVIOUS PREVIOUS PREVIOUS

Address

Contact no.

Email id

Role

Net salary
Reason for leaving

Can We Contact Your Previous Employer for Reference? ☐ YES ☐ NO

7. STATUTORY BENEFITS DETAILS

1) PF

Were you entitled to PF Benefits in your Previous Organisation ☐ YES ☐ NO

Would you like to continue with the same UAN Number in our ☐ YES ☐ NO
Organisation as well ?
(If yes, please attach your EPF Passbook and UAN Card of Previous employment and fill the information
below)

UAN Number of Previous Employment:

PF Number of Previous Employment:

2) ESIC
*Kindly note to fill the information below only if your gross salary is below 21000 in our organisation

Were you entitled to ESIC Benefits in your Previous Organisation ☐ YES ☐ NO

Would you like to continue with the same ESIC Number in our ☐ YES ☐ NO
Organisation as well ?
(If yes, please attach your ESIC Card/E-Pehchan Card and fill the information below)

ESIC Number: _____________________________________________

Page 4
 7. DETAILS OF REFERENCE AND REFERRAL CONTACTS

References are your former colleagues who can talk about your work experience, work habits,
character, and skills.

PARTICULARS REFERENCE CONTACT 1 REFERENCE CONTACT 2

Designation

Relationship

Contact Number

Email Id

Referral refers to a potential candidate whom you can consider suitable for a particular position in
your institution.

PARTICULARS REFERRAL CONTACT 1 REFERRAL CONTACT 2

Name Of the Referral

Position referred for

Relationship
Contact Number
Email Id
Reason why the
Candidate is suitable for
the position

Page 5
 8. DECLARATION

I hereby certify that all the statements made, and information given by me in this form is True, Complete,
and Correct to the best of my knowledge and belief. In the event of any information or part of it being found
false or incorrect before/after the Interview or Appointment, action can be taken against me by the
concerned authority and my candidature shall automatically stand cancelled/terminated.
I authorize the investigation of all statements contained in this form as may be necessary in arriving at an
Employment decision. In the event of employment, I understand that false or misleading information given
in my application or interview(s) may result in discharge.

Place: Signature:

Date:

Page 6