application format for employment fcri

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  • 8/2/2019 Application Format for Employment Fcri

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    CONFIDENTIAL

    P&A Ref no:

    FLUID CONTROL RESEARCH INSTITUTE

    (An Autonomous R&D Institute under Ministry of Industry)

    Dept. of Heavy Industry, Government of India)

    Kanjikode West, Palakkad -678 623, Kerala, India.

    Phone No: 0491-2566206, 2566120, 2566119; Fax: 0491-2566326

    (A Premier Institute in South East Asia for R & D on flow products, Testing and

    Calibration of valves, flowmeters and other measuring instruments as per ISO

    requirements, Software for Design & Selection of Flowmeters / Valves and Specialised

    Training Programs)

    Advertisement No. :

    Postal Order No. :

    (Date & amount)

    Post applied for :

    Name in (BLOCK CAPITAL) full

    Fathers name & Occupation

    Present Address

    Permanent Address

    Telephone nos.

    Date of Birth & Age

    Marital Status

    Nationality

    State of domicile & mother tongue

    Religion /Caste

    Do you belong to /Scheduled Caste /

    Scheduled Tribe

    Languages known

    Indicate specific reasons for leavingyour previous employer:

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    PHOTO

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    ACADEMIC RECORDS

    YearCourse & Specialisation

    School / College /

    University & Institute

    Class &

    %age of marksFrom To

    SHORT TERM COURSE/PROFESIONAL TRAINING PROGRAMMES:

    DETAILS OF EXPERIENCE (Including present Appointment)

    Year &month Employers Name &

    Nature of Business

    Designation Gross Monthly Salary

    From To Starting Leaving/ present

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    Indicate specific reasons for leaving your previous employer:

    Name & address of previous employer Specific reasons for leaving

    Why do you want to leave your present

    employer?

    Your achievements like outstanding contributions in your previous employment, sports, cultural,

    literature, associations etc.

    Have you ever been discharged/dismissed / terminated / or any type of disciplinary action taken against

    you for misconduct or unsatisfactory service or involved in any court proceedings, if so give details:

    Give two references (not related to you) who are well acquainted with your background, service career

    and character etc.

    Name Occupation Address

    Time required to join duty if selected

    Minimum gross salary expected in the

    position applied for

    Rs.

    Do you posses a vehicle? Your license no.:

    Vehicle registration no.:

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    DETAILS OF YOUR FAMILY MEMBERS:

    Member Name Nationality

    (by birth

    and /or by

    domicile)

    Place of

    birth

    Occupation (if employed

    give Official address &

    gross monthly income)

    present postal address (if

    dead give last address)

    Permanent

    Home

    address

    Father (Namein full,

    address, if

    any)

    Mother

    Wife/Husband

    Brother/Sisters

    Any relevant information that you may wish to furnish:

    Declaration

    I hereby certify that the particulars furnished as above are true, correct and complete in all

    respects. I agree and accept without reservation that at any time, if any of the particulars is found

    to be untrue, incorrect and/or incomplete, my appointment in the institute may be terminated with

    out notice.

    Place: Signature of Applicant

    Date:

    Note: Please furnish full and detailed information under each item and if the space provided in

    any column is in sufficient separate sheets may be attached.

    For use of P & A only

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    FCRI/ADMN/GEN/01

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