Employment Application Form
Please affix your passport size photo here
Please read the below instructions carefully before you start filling in t he requested information:
1) Please read all instructions for each section and fill in as instructed. All fields are to be filled legibly, completely and accurately in CAPITAL letters to reduce delay in processing your candidature with IBM. 2) Please bring the following documents with you to the personal interview at IBM: i) Completed IBM IBM Employment Application Form ii) Proof of of Salary Salary Documents Documents Offer letter with compensation break up OR Latest increment letter from present organization with compensation break-up iii) Updated Resume iv) Valid Photo ID ID (Passport, PAN Card, Card, Voter’s ID card, card, Driver’s License) Past IBM Interview Details (Fill in CAPITAL CAPITAL Letters) Have you attended any IBM Interview in the last 3 Months
Yes
No
If Yes, please provide the below details: D
D
M
M
M
Y
Y
Y
Y
Date of Interview Position Applied
Work in P rogress
Received Offer
Rejected/Declined
IBM India P vt L td
IBM Daksh
IBM NetSol
Location Of Interview IBM subsidiary Name
Page 1 of 6, Employment Application form, version 5.0, wef - 06th Aug 2012
1
SOURCE INFORMATION (Fill in CAPITAL Letters) How did you know about this vacancy in IBM? (Select any one of the below)
Agency
Direct - IBM Website
Accepted Not J oined Candidate
IBM Employee Referral
Agency name
Name of the Employee
Employee Number (If Applicable)
It is important that you mention the employee ID or Email ID accurately, please confirm with the referrer if you are not sure of the information
Jobsites Job Site Name
E- Mail ID
By submitting the IBM Employee Referral name you confirm that the referrer is known to you personally or professionally. This relationship may be a result on account of participation in various social networks which are either formal (examples of formal networks are Linkedin, Facebook, Twitter, industry and competency associations) or informal (examples of informal networks are former employment with the same company, friends circle, alumni from same educational institution or study circles) . You also confirm that the referrer has made you aware that by referring your candidature to IBM for an opportunity of employment, he/she may be eligible to receive a referral bonus.
IBM Application ID *
C
* If you have already registered on our IBM Job Portal please provide the IBM Candidate Applicant ID also called GOM Candidate Applicant ID. If you are referred by an Agency, please ask your agency for the Applicant ID
PERSONAL INFORMATION (Fill in CAPITAL Letters) * Enter your name as per your Passport, Driver's Licence OR PAN Card ( For Indian Nationals) Title Mr.
Ms.
First Name
Middle Name
Last Name
D
D
M
M
M
Y
Y
Y
Y
Date of Birth **e.g. 01 - JAN - 1900
Mobile Number **Country code - Mobile Number Telephone
**Country code - City Code - Telephone Number
Personal Email ID
Pan Card
(If you are an Indian National)
Driver's Licence #
Passport Number
D
D
M
M
M
Y
Y
Y
Y
Expiry
Place of Issue Refer to the passport for this information Page 2 of 6, Employment Application form, version 5.0, wef - 06th Aug 2012
2
PERSONAL INFORMATION…… CONTINUED (Fill in CAPITAL Letters)
Nationality
City of Birth
Country of Birth
Current Address
PIN Code
City State Country Permanent Address (If different from the above)
PIN Code
City State Country
PROFESSIONAL REFERENCES (Fill in CAPITAL Letters) Please provide details of three professional references with whom you have had a business/Working relationship of which one reference has to be mandatorily your previous Manager's details Please exclude Friends, Colleagues, Juniors, Relatives at work and Clients Name
Contact Number
Nature of professional Relationship
Current occupation
Comments*
*Please use the comments column to indicate if you do not wish IBM to contact one or any of the above for pre-reference checks.
Page 3 of 6, Employment Application form, version 5.0, wef - 06th Aug 2012
3
EDUCATION DETAILS (Fill in CAPITAL Letters) COMPLETED degree programs only.
Please complete all fields, even if you have already provided a resume. Provide details on Highest Qualification (Completed)** e.g.: M.Sc, B.Com ** Highest education declared has to be minimum 02 year degree or diploma awarded by a University or a Board or its affiliates
PLEASE MENTION COMPLETE DETAILS OF SCHOOL / COLLEGE / INSTITUTION AND UNIVERSITY NAME ALONG WITH COMPLETE ADDRESS WITH CITY & POSTAL CODE IN CAPITAL LETTERS
Qualification
Complete Name & Address of School / College / Institution and Name of the University *University name is mandatory where applicable(DO NOT ABBREVIATE)
Course Tenure
M
M
Class/ Registration / Division/ Roll / Final Percentage/ Year Seat Grade Number Points
M
Y
Y
Y
Y
Y
Y
Name of the Degree Awarded (e.g.. B.com / BA/ Mtech)
Start Date SSLC ( 10th) End Date Year of Passing
* E.g. JAN09 M
M
M
Start Date HSLC (12th) End Date Year of Passing
* E.g. JAN09
M Graduation
M
M
Start Date End Date University Name
Year of Passing
* E.g. JAN09
M Post Graduation
M
M
Y
Y
Start Date End Date University Name
Year of Passing
* E.g. JAN09
M
M
M
Y
Y
Others - PhD, Start Date Additional Degrees End Date University Name
Year of Passing
* E.g. JAN09 Professional Qualification Start Date (Other than already End Date mentioned above) like CA, Year of Passing CFA etc
M
M
M
Y
Y
* E.g. JAN09 State reasons for GAP in education, if any : Professional Training (includes in progress degrees) - please mention the details ______________________________________________________________________________________________________________________________________________ Page 4 of 6, Employment Application form, version 5.0, wef - 06th Aug 2012
4
EMPLOYMENT HISTORY (Fill in CAPITAL Letters)
Provide your job history for a minimum of the last five (5) years (if applicable). Additionally, include your last three 3 employers (if applicable) even if your total service exceeds 5 years in the last 1 or 2 companies. Please include information on Self employment within the same period. Do you have prior employment experience?
Yes
No
PLEASE MENTION COMPLETE DE TAILS OF ORGANISATION NAME, COMPLETE ADDRESS WITH STREET NAME, AREA, CITY & POSTAL CODE IN CAPITAL LETTERS Employment Type (Permanent Organisation Name and address /Contractual) and Tenure Band / Grade details
Serial No Organisation Name
D
D
D
D
M
M
M
Y
Y
Y
Y
Y
Y
Employee Number
Full Time / Part Time
Start Date
Address
1
End Date * E.g. 01-JAN-1900
Pin Code Organisation Name
M
M
M
Start Date
Address
2
End Date * E.g. 01-JAN-1900
Pin Code Organisation Name
D
D
M
M
M
Start Date
Address
3
End Date * E.g. 01-JAN-1900
Pin Code
Below is continuation of the above table. E.g. Continue to fill in details of "Serial No 1" (Above) in "Serial No 1-Continue" row below. Serial No
Designation
Reasons for Leaving
Reporting Manager's Name and contact number)*
If Employment Type is Contractual, Please Provide Agency Name, COMPLETE Address and Contact Number
Organisation Name Complete Address
1Continue
Pin Code Organisation Name
Contact Number
EMPLOYMENT HISTORY (Fill in CAPITAL Letters)
Provide your job history for a minimum of the last five (5) years (if applicable). Additionally, include your last three 3 employers (if applicable) even if your total service exceeds 5 years in the last 1 or 2 companies. Please include information on Self employment within the same period. Do you have prior employment experience?
Yes
No
PLEASE MENTION COMPLETE DE TAILS OF ORGANISATION NAME, COMPLETE ADDRESS WITH STREET NAME, AREA, CITY & POSTAL CODE IN CAPITAL LETTERS Employment Type (Permanent Organisation Name and address /Contractual) and Tenure Band / Grade details
Serial No Organisation Name
D
D
D
D
M
M
M
Y
Y
Y
Y
Y
Y
Employee Number
Full Time / Part Time
Start Date
Address
1
End Date * E.g. 01-JAN-1900
Pin Code Organisation Name
M
M
M
Start Date
Address
2
End Date * E.g. 01-JAN-1900
Pin Code Organisation Name
D
D
M
M
M
Start Date
Address
3
End Date * E.g. 01-JAN-1900
Pin Code
Below is continuation of the above table. E.g. Continue to fill in details of "Serial No 1" (Above) in "Serial No 1-Continue" row below. Serial No
Designation
Reporting Manager's Name and contact number)*
Reasons for Leaving
If Employment Type is Contractual, Please Provide Agency Name, COMPLETE Address and Contact Number
Organisation Name Complete Address
1Continue
Contact Number
Pin Code Organisation Name Complete Address
2Continue
Contact Number
Pin Code Organisation Name Complete Address
3Continue
Contact Number
Pin Code
*Current Reporting Manager will be contacted ONLY AFTER the candidate joins IBM Total years of experience - (please do not include any training or internship experience) State GAP in Employment if any:
Years
Months
5
Page 5 of 6, Employment Application form, version 5.0, wef - 06th Aug 2012
Present Employment Compensation Details** (Fill in CAPITAL Letters) ** The information stated here must be supported with documentary evidence (Offer letter from present organization including Compensation break up details or most recent increment letter) Please mention below your annual compensation details (A). Fixed Pay including statutory benefits (Rs.)
(B).Variable Pay (Rs.)
Annual Current CTC = Total of A + B + C (Rs.)
Comments
(C). Other allowances (Rs.)
OTHER DETAILS (Fill in CAPITAL Letters) Have you worked for IBM earlier?
Yes
No
If "YES", please provide following details: Tenure (DD-MMM-YYYY) Business Unit
Location
Date of Joining
Last working day
Are you willing to relocate as part of your employment with IBM? If "YES", please indicate your preference
Yes
Manager's Name
Status (Regular/FTH/Contractor)
Employee No. / Contractor Code
No
_______________________________________________________________________
Present Employment Compensation Details** (Fill in CAPITAL Letters) ** The information stated here must be supported with documentary evidence (Offer letter from present organization including Compensation break up details or most recent increment letter) Please mention below your annual compensation details (A). Fixed Pay including statutory benefits (Rs.)
(B).Variable Pay (Rs.)
Annual Current CTC = Total of A + B + C (Rs.)
Comments
(C). Other allowances (Rs.)
OTHER DETAILS (Fill in CAPITAL Letters) Have you worked for IBM earlier?
Yes
No
If "YES", please provide following details: Tenure (DD-MMM-YYYY) Business Unit
Location
Date of Joining
Last working day
Yes
Are you willing to relocate as part of your employment with IBM? If "YES", please indicate your preference
Status (Regular/FTH/Contractor)
Manager's Name
Employee No. / Contractor Code
No
_______________________________________________________________________
If you are related to IBM India Private Limited employees and/or Directors (sibling / spouse/ children/in law relationships), please provide names and relationship. Name
Designation
Business Unit
Relationship
Consistent with IBM's policy on workforce diversity and in order to accommodate employee's special needs in the work environment, please indicate if you are physically challenged **
Yes
No
If yes, please provide description of disability and accommodation required: ** IBM Corporation is an Equal Employment Opportunity Employer
Do you have any non-compete obligations or conflict situations or other restrictive clauses with any party including any of your previous employers that prevent you from working for IBM India Private Limited?
Yes
Have you worked for the Government, whether as a civilian employee or member of the military?
No
Yes
No
All Candidates must indicate if they have worked for the Government, whether as a civilian employee or member of the military. If so, you must also indicate whether you had any responsibilit ies or were involved in activities relat ing to IBM or an affiliated Company. You must also state whether you are aware of any legal restricti ons on what work you may do for IBM or an affiliated Company, and if so, what those restrictions are. Name of Government Organization and Department Tenure Job Responsibilities Restictions ( if any)
Declaration • If applicable, I hereby confirm that in my duties as a government employee, I have (or have had) no matters involving IBM (in any capacity whatsoever), or if I do, that I have officially withdrawn from participating in those matters while I am discussing potential employment with IBM. All details of any such matters that I have been involved with, where IBM or any of its affiliates have been involved, are listed above. • I confirm that the information provided by me in this application form is complete and accurate. • I understand that if any information provided by me with respect to my application for employment is found to be untrue, inaccurate or misleading, IBM INDIA Private Limited may withdraw any offer of employment made to me or terminate my employment (If I have already joined IBM India) without notice. • I understand that all the details provided in this application are subject to verification. • I hereby authorize IBM India Private Limited and its representatives (including reference check agencies/third party vendors) to verify information provided in my application for employment and to conduct enquiries as deemed necessary by the company. • I authorize all persons who have information regarding my education, employment, and all other details provided in this form, to disclose it to IBM or its representative.
Signature:
Place: Page 6 of 6, Employment Application form, version 5.0, wef - 06th Aug 2012
Date:
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