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Thank you for your interest in Wipro. This form is intended to
enable you to record important pointsabout yourself, your
experience, your achievements and your plans for the future. Please
completethe form in full and use additional sheets if necessary.
When we meet you at the interview, thecontents of this application
will provide a base for our interaction.
WWW.WIPRO.O!
APPLICATION FOR EMPLOYMENT
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PERSONAL INFORMATION
"irst #ame !iddle #ame $ast #ame!r %bhi&it #ivrutti
'hinde
( )xpand all names*
+ate of irth
+-
+-
!
!-
/-
/0
/1
/2
e3mail [email protected]
urrent %ddress 4"lat #o35 ,lock no356,Paschima#a7ari ,8othrud
,Pune
ity3 Pune 'tate Mahaash!a PI#Phone (with'T+ code*
Office
Res. 5 2 2 5 2 - 6 6
Permanent %ddress 4
"lat #o3-9,Radha8rishna :ousin7 . 'ociety Pimpal7aon aswant
,#asik
ity #asik 'tate !aharashtra PI# Phone(with 'T+code*
5 2 2 5 2 - 6 6
!obile 0 1 0 5 1 ; 1 ; -
E"#$ATION
(e7in with the most recent @niversity $ocation Araduatio
n(!onth>/r.
*
%77re7ate!arks
(B or AP%*
%.E. $OMP#TERS$IEN$E
Sinhga& $ollege O' Engineeing (PunePune )une
2006*+.,+-
.S.$S$IEN$E /.. 1agh $ollege .Pimalgaon
%as3an! (Nasi
Nasi Feb 2002 45.6+-
S.S..$ Pimalgaon ighSchool( Pimalgaon%as3an! (Nasi
Nasi Mach2000
45*7-
TRAININ8Trainin7>+evelopment Pro7rammes attended > IT
'kills
ac
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Reason "or $eavin7%e!!e 1o Po'ile ()ob Sa!is'ac!ion
(In&i;i&ual 8o3!h
'upervisorCs #ame D +esi7nation D )!%I$ I+an we take reference
from your supervisorE /esNo
MONTL= EMOL#MENTS
"ixed 'alary Fariable > Perks +eferred benefitsasic
,0(000:ousin7
P", Pension, Aratuity etc.(*
onus>Incentives ompany car
%llowances,0(000
"urnishin7s
Others(please specify* Others
(please specify*
Total (%*20(000
Total (*
!onthly Aross (%GG* 20(000
urrent %nnual Aross 2(50(000
E9ec!e& Annual8oss
5(40(000
+o you have employee stock optionsE /es No
If yes, #ett 7ain at current value 4H(urrent !arket Price Issue
price* x #o. of stocksJ
PRIOR TO PRESENT LAST EMPLO=MENT#ame of the )mployer
+ates )mployed "RO! TO
%ddress 4
Phone 4
/our +esi7nation )mployee ode Responsibilities
Reason "or $eavin7 !onthly Aross4 3
PREIO#S EMPLO=MENT "ETAILS#ame of the or7ani?ation $ocation
+esi7natio
n)mployee ode
+uration !onthly 'alary
"rom To 'tartin7 "inal
Reason for$eavin7
%i!3ise P;! Solu!ions(Pune
PunePogamme
0700 26 )une2006 Till "a!e ,5(000 20(000
%e!!e 1oPo'ile
A%O#T =O#RSELFThe answers to the followin7
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/our career ob&ectivesE
To secue a osi!ion 3hee b? ha& 3o( &e&ica!ion
an&!he abili!? !o acBuie ne3 sills 3ill a&;an!age an?coman?
I 3o 'o.
/our expectations from the &ob>WiproE
8oo& 1o Po'ile( Encouagemen! !o lean ne3!echnologies
'IA#I"I%#T %:I)F)!)#T'4 +istinctions, :onours, %wards(
%cademic>extra curricular * received
8o! E9cellence A3a& 'o Ma? 200+ an& No;embe 2006 in
%i!3ise Pune
OT:)R I#T)R)'T'4 ultural, sports, community work and hobbies
from school onwards D details of memberships ofassociationSocial
Ac!i;i!ies
REFEREN$ESAive references under whom you have either worked or
who know you professionally for at least 9 months.
#ame +uration D#ature of
%ssociation
Or7ani?ation D +esi7nation e3mail Phone (with 'T+ code*
:ome Office
Ami! 8ulhane , =eaTeamLea&
%i!3ise PuneO''>
Pe>[email protected]
0202*6C076*
O''>
Pe>
O''>
Pe>
A""ITIONAL "ETAILS
#ationality In&ian OthersIf Others, 'pecify #ationality
4
+o you have work permit to work in IndiaE /es#o
+o you hold a valid PassportE =es#o(for Indian citi?ens
only*
If /es, Passport #o 4 87*+,057
Falid till 4 ,,06200+
:ave you been denied FI'% to any countryE /esNo
If /es, +etails
:ave you worked on overseas assi7nmentsE /esNo
If yes, provide details on countries visited and type of
Fisasheld
:ave you attended any selection process at /esNo
Wipro beforeE
If /es, +ivision 4 $ocation 4
!onth>/ear4 'tatus 4+o you have any relative > friend
employedwith WiproE /esNo
If /es, his>her name 4+ivision>$ocation 4
:ave you suffered from any ma&or illness>sur7ery
>accident in the last five yearsE /esNo
If /es, +etails
:ave you ever been arrested, prosecuted or convicted for
anycriminal offense, other than minor traffic offenses E/es NoIn
the last ten years, have you been convicted of or plead 7uiltyto
any offenceEIn the last ten years have you been released from
prison on aconvictionE
If /es, furnish details includin7 type of offense
andconviction
/es ( * #O ( *
/es ( * #O ( *
+o you have any commitment to another employer or or7ani?ation
that mi7ht affect your employment with usE /esNo
%ny other information you would like us to know which may have
si7nificant bearin7 on our hirin7 decision 4
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1OR/ LO$ATIONS%re you willin7 to be posted anywhere in IndiaD
=es#o
%re you willin7 to be posted abroadE =es #o
Indicate your preferred work location in India Pune
I hereby declare that my statements on this application and on
my resume or documents provided by me to Wipro are correct tothe
best of my knowled7e. I acknowled7e and a7ree that providin7 any
false information may result in a decision not to hire me orif
hired, may result in termination of my employment. I 7ive consent
to Wipro to institute and conduct a back7round check to verifythe
information furnished by me in this form.
+ate4 9 %u7 ,5; Place4 Pune 'i7nature4
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