APPLICATION FORM Please fill in the details with utmost attention, as these shall be verified by Cognizant Technology Solutions and/ or by its authorized representatives.

All details are compulsory.

PERSONAL DETAILS

Name of Applicant: Surname Middle First

Date of Birth (dd/mm/yy): Marital Status:Home Phone: STD Code Number

Place of Birth: Nationality:Office Phone: STD Code Number

Sex: Passport No.: Mobile:

E-mail id:

RESIDENTIAL ADDRESSES

CURRENT ADDRESS:

City: State: Pin Code: Phone No.:

Duration of Stay: From (mm/yy) To (mm/yy)Nature of location: Rented Own Other (Specify)

PERMANENT ADDRESS:

City: State: Pin Code: Phone No.:

Duration of Stay: From (mm/yy) To (mm/yy)Nature of location: Rented Own Other (Specify)

LONGEST STAY ADDRESS IN THE LAST SEVEN YEARS:

City: State: Pin Code: Phone No.:

Duration of Stay: From (mm/yy) To (mm/yy)Nature of location: Rented Own Other (Specify)

All details are compulsory Strictly Private & Confidential

Please Affix Your Passport Size Photograph

FAMILY DETAILS

RELATION NAME AGE EDUCATION OCCUPATION DEPENDANT (Y/N)

FATHER

MOTHER

SPOUSE

CHILDREN

BROTHERS

SISTERS

EDUCATION DETAILS

QUALIFICATION

NAME & ADDRESS OF

SCHOOL / COLLEGE/ INSTITUTE

NAME & ADDRESS OF BOARD / UNIVERSITY

TO WHICH THE SCHOOL / COLLEGE / INSTITUTE

IS AFFILIATED TO

COURSE ATTENDED

(MORNING/ EVENING/

CORRESPONDENCE)

MARKS (%) CGPA

& CLASS

DATES ATTENDED ROLL

NUMBER/ REGISTRATIO

N NUMBER/ EXAM SEAT

NUMBER

YEAR OF

ENROLMEN

T (MM/YY)

YEAR PASSED (MM/YY)

SSC (X TH GRADE)

HSC (XII TH GRADE)

GRADUATION

DEGREE:

DISCIPLINE:

POST GRADUATION

DEGREE:

DISCIPLINE:

ANY OTHER

All details are compulsory Strictly Private & Confidential

REASONS FOR BREAKS IN EDUCATION: ______________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

SKILL SET: (MENTION SKILLS YOU ARE APPLYING FOR):

SKILLSTOTAL EXPERIENCE

(IN MONTHS)* SELF RATING

* (Please follow this Rating Scale for each skill: -4 - Excellent, 3 - Good, 2 - Average, 1 – Beginner)

WILLINGNESS TO WORK ANYWHERE IN INDIA: YES NO

WILLINGNESS TO WORK ANYWHERE OUT OF INDIA: YES NO

PRIOR INTERNATIONAL EXPERIENCE: YES NO

DURATION OF ONSITE ASSIGNMENTS ABROAD IN MONTHS: _________________

PASSPORT DETAILS:

AVAILABILITY YES NO

IF YES, PASSPORT NO:

VISAS STAMPED

(LIST OF COUNTRIES):

VISA REJECTION HISTORY:

REASONS FOR REJECTION:

All details are compulsory Strictly Private & Confidential

EMPLOYMENT RECORD: Starting with your present or most recent employer, please list all employments during the last five years. Include military service, temporary, part-time and summer work. When listing consulting or temporary assignments, under “Employer”, state the name of the consulting or temporary agency that placed you at the client site. Complete and accurate dates (month/year) must be provided. For compensation sections, specify currency and basis for salary (i.e. monthly or yearly).

CURRENT EMPLOYER: Employee Id: From (mm/yy): To (mm/yy):

Street Address: Employer’s Phone No.:

Fax No.:

City: State: Country: Postal Code:

Job Title: Description of Duties:

Employment Status: (Please check the relevant box)

Full Time Contract /Through Outsourcing Agency

Outsourcing Agency Details:Name:Address:

Tel No.:

Supervisor’s Details:

Name:

Title:

Phone No.:E-mail id:(Preferably official)HR Manager’s Details:Name:

Reason for leaving: Phone No.:E-mail id:(Preferably official)

EMPLOYER 1: Employee Id: From (mm/yy): To (mm/yy):

Street Address: Employer’s Phone No.:

Fax No.:

City: State: Country: Postal Code:

Job Title: Description of Duties:

Employment Status: (Please check the relevant box)

Full Time Contract /Through Outsourcing Agency

Outsourcing Agency Details:Name:Address:

Tel No.:

Supervisor’s Details:

Name:

Title:

Phone No.:E-mail id:(Preferably official)HR Manager’s Details:Name:

Reason for leaving: Phone No.:E-mail id:(Preferably official)

All details are compulsory Strictly Private & Confidential

EMPLOYMENT RECORD CONTINUED: EMPLOYER 2: Employee Id: From (mm/yy): To (mm/yy):

Street Address: Employer’s Phone No.:

Fax No.:

City: State: Country: Postal Code:

Job Title: Description of Duties:

Employment Status: (Please check the relevant box)

Full Time Contract /Through Outsourcing Agency

Outsourcing Agency Details:Name:Address:

Tel No.:

Supervisor’s Details:

Name:

Title:

Phone No.:E-mail id:(Preferably official)HR Manager’s Details:Name:

Reason for leaving: Phone No.:E-mail id:(Preferably official)

EMPLOYER 3: Employee Id: From (mm/yy): To (mm/yy):

Street Address: Employer’s Phone No.:

Fax No.:

City: State: Country: Postal Code:

Job Title: Description of Duties:

Employment Status: (Please check the relevant box)

Full Time Contract /Through Outsourcing Agency

Outsourcing Agency Details:Name:Address:

Tel No.:

Supervisor’s Details:

Name:

Title:

Phone No.:E-mail id:(Preferably official)HR Manager’s Details:Name:

Reason for leaving: Phone No.:E-mail id:(Preferably official)

All details are compulsory Strictly Private & Confidential

EMPLOYMENT RECORD CONTINUED: EMPLOYER 4: Employee Id: From (mm/yy): To (mm/yy):

Street Address: Employer’s Phone No.:

Fax No.:

City: State: Country: Postal Code:

Job Title: Description of Duties:

Employment Status: (Please check the relevant box)

Full Time Contract /Through Outsourcing Agency

Outsourcing Agency Details:Name:Address:

Tel No.:

Supervisor’s Details:

Name:

Title:

Phone No.:E-mail id:(Preferably official)HR Manager’s Details:Name:

Reason for leaving: Phone No.:E-mail id:(Preferably official)

Note: Incase of more than three employer’s during the last five years of employment, kindly attach an additional employment sheet and fill in the details.

REASONS FOR BREAKS IN EMPLOYMENT HISTORY: ______________________________________________ ____________________________________________________________________________________________

SIGNIFICANT ACHIEVEMENTS (FROM PREVIOUS EMPLOYMENTS): ____________________________________________________________________________________________ ____________________________________________________________________________________________

EXPECTATIONS FROM COGNIZANT (ROLE/RESPONSIBILITY): ____________________________________________________________________________________________ ____________________________________________________________________________________________ YOUR KEY STRENGTHS/WEAKNESS: ____________________________________________________________________________________________ ____________________________________________________________________________________________

CURRENT SALARY DETAILS:

BASIC: OTHER ALLOWANCES: TOTAL ANNUAL PACKAGE:

HRA: MEDICAL: EXPECTED SALARY AT COGNIZANT (INR):

PF: CONVEYANCE:

LTA: TOTAL MONTHLY:

All details are compulsory Strictly Private & Confidential

PROFESSIONAL REFERENCES

PARTICULARS REFERENCE 1 REFERENCE 2

NAME

DESIGNATION

COMPANY

LANDLINE

MOBILE

E- MAIL

ADDRESS

YOUR SHORT TERM AND LONG-TERM GOALS: ___________________________________________________________________________________________ ___________________________________________________________________________________________ ANY OTHER DETAILS YOU WOULD LIKE TO MENTION (CERTIFICATIONS/PRESENTATIONS MADE ETC,) ___________________________________________________________________________________________ ___________________________________________________________________________________________

AFFIDAVIT

I certify that the statements made in this application are valid and complete to the best of my knowledge. I understand that Cognizant Technology Solutions is an at will employer, false or misleading information may result in termination of employment, with or without cause and with or without notice. I understand that Cognizant Technology Solutions may request a credit and/or background check from a credit reporting agency or related service. I understand that I have a right to make a written request within a reasonable time for the disclosure of the name and address of the credit-reporting agency so that I may obtain a complete disclosure of the nature and scope of any investigation. I understand that the records will be used for employment purposes only and will not be given to unauthorized persons. I authorize Cognizant Technology Solutions, and/or its agents to conduct a reference check so that a hiring decision may be made. In the event that Cognizant Technology Solutions is unable to verify any reference stated in this application, it is my responsibility to furnish the necessary documentation. I understand that this application or subsequent employment does not create a contract of employment nor guarantee employment for any definite period of time. I have read, understood, and by my signature consent to these statements.

SIGNATURE:

NAME (IN BLOCK LETTERS): DATE:

DOCUMENTS REQUIRED (COMPULSORY) Completed & Signed Application Form Two Passport Size Photographs

Copy of Relevant Education Certificates Current Address Proof (if stay at current address > 6 months) else Longest Stay Address Proof.

Please note: Your name should be mentioned on the address proof.

Accepted address proofs: MTNL Bill / Electricity Bill/ Copy of Rent Agreement/ Passport/ Voter Id/ Driving License.

Copy of all past Employment Relieving Letters / Salary Slips

All details are compulsory Strictly Private & Confidential