PERSONAL INFORMATION

FULL NAME: SIDDHESH DILIP PAWAR DATE: 1ST JULY 2025

ADDRESS: SURAKSHA NAGAR B-22 RIL NMD , NAGOTHANE,

MAHARASHTRA,402125
City State Zip Code

E-MAIL: [email protected] PHONE: 7741894020

SOCIAL SECURITY NUMBER (SSN): _____-____-_____

DATE AVAILABLE: __________________ DESIRED PAY: $_________ ☐ HOUR ☐ SALARY

EMPLOYMENT ELIGIBILITY

ARE YOU LEGALLY ELIGIBLE TO WORK IN THE U.S? ✓ YES ☐ NO*

HAVE YOU EVER WORKED FOR THIS EMPLOYER? ☐ YES* ✓ NO

*IF YES, WRITE THE START AND END DATES: ____________________________________

*IF YES, PLEASE EXPLAIN: ____________________________________________________

EDUCATION

SCHOOL: Reliance foundation school (SSC) CITY / STATE: Nagothane, Maharashtra

FROM: June 2021 TO: June 2022

GRADUATE? ✓ YES ☐ NO DIPLOMA: Instrumentation and Control

COLLEGE: Government Polytechnic Pen CITY / STATE: Pen, Maharashtra

FROM: June 2022 TO: June 2025

GRADUATE? ☐ YES ✓ NO DEGREE: ___________NA__________

OTHER: _____________________ CITY / STATE: _____________________

FROM: _____________________ TO: _____________________

DEGREE/CERTIFICATION: _____________________

OTHER: _____________________ CITY / STATE: _____________________

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FROM: _____________________ TO: _____________________

DEGREE/CERTIFICATION: _____________________

PREVIOUS EMPLOYMENT

EMPLOYER 1: __________________________________________________________
Company / Individual

E-MAIL: __________________________________ PHONE: _____________________

ADDRESS: ____________________________________________________________
Street Address Apt/Suite

____________________________________________________________
City State Zip Code

STARTING PAY: $_________ ☐ HOUR ☐ SALARY ENDING PAY: $_________ ☐ HOUR ☐ SALARY

JOB TITLE: ______________ RESPONSIBILITIES: _____________________________

FROM: _____________________ TO: _____________________

REASON FOR LEAVING: _______________________________________________________

EMPLOYER 2: __________________________________________________________
Company / Individual

E-MAIL: __________________________________ PHONE: _____________________

ADDRESS: ____________________________________________________________
Street Address Apt/Suite

____________________________________________________________
City State Zip Code

STARTING PAY: $_________ ☐ HOUR ☐ SALARY ENDING PAY: $_________ ☐ HOUR ☐ SALARY

JOB TITLE: ______________ RESPONSIBILITIES: _____________________________

FROM: _____________________ TO: _____________________

REASON FOR LEAVING: _______________________________________________________

EMPLOYER 3: __________________________________________________________
Company / Individual

E-MAIL: __________________________________ PHONE: _____________________

ADDRESS: ____________________________________________________________
Street Address Apt/Suite

____________________________________________________________
City State Zip Code

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STARTING PAY: $_________ ☐ HOUR ☐ SALARY ENDING PAY: $_________ ☐ HOUR ☐ SALARY

JOB TITLE: ______________ RESPONSIBILITIES: _____________________________

FROM: _____________________ TO: _____________________

REASON FOR LEAVING: _______________________________________________________

REFERENCES
(PROFESSIONAL ONLY)

FULL NAME: DILIP PAWAR RELATIONSHIP: FATHER

COMPANY: RELIANCE FOUNDATION SCHOOL TITLE: TEACHER

E-MAIL: [email protected] PHONE: 9518345294

FULL NAME: SAROJ PAWAR RELATIONSHIP: MOTHER

COMPANY: ________________NA________________ TITLE: HOMEMAKER

E-MAIL: [email protected] PHONE: 9021395335

FULL NAME: SAMRUDDHI PAWAR RELATIONSHIP: SISTER

COMPANY: _________________NA_______________ TITLE: STUDENT

E-MAIL: [email protected] PHONE: 7020809514

MILITARY SERVICE

ARE YOU A VETERAN? ☐ YES ☐ NO

BRANCH: _____________________ RANK AT DISCHARGE: _____________________

FROM: _____________________ TO: _____________________

TYPE OF DISCHARGE: _____________________

IF NOT HONORABLE, PLEASE EXPLAIN: ______________________________________

BACKGROUND CHECK CONSENT

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IF ASKED, ARE YOU WILLING TO CONSENT TO A BACKGROUND CHECK? ✓ YES ☐ NO

DISCLAIMER

Applicant understands that this is an Equal Opportunity Employer and committed to excellence
through diversity. In order to ensure this application is acceptable, please print or type with the
application being fully completed in order for it to be considered.

Please complete each section EVEN IF you decide to attach a resume.

I, the Applicant, certify that my answers are true and honest to the best of my knowledge. If this
application leads to my eventual employment, I understand that any false or misleading
information in my application or interview may result in my employment being terminated.

SIGNATURE _________________________________ DATE 1st July 2025

NAME Siddhesh pawar

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