Authorization Form
Photo
Please be assured that this information will be used only for recruitment purposes and
nothing else. Please put in your details in the form below. Kindly provide immediate
contact nos., and correct information, this will enable us to complete the process at the
earliest.
Applicant ‘s name
VISHAL NANDINI GOSWAMI
Father’s name
MANOJ KUMAR GOSWAMI
Date of birth 07/06/2000
Permanent Address 13/117 , KACHAHARI Present address L4-17 , RING ROAD ,
MOHALLA , JUGSALAI , JAMSHEDPUR - TELCO COLONY , TELCO , JAMSHEDPUR -
831006 831004
House No. : 13/117 H. No. : L4-17
Street, Block Colony : KACHAHARI Street : RING ROAD
MOHALLA
City : JAMSHEDPUR City : JAMSHEDPUR
State : JHARKHAND State : JHARKHAND
Telephone No. : 7979980692 Tel. No.: 7979980692
Give three references not related to you (at least one from your previous employer)
Name of Organization Telephone No E-Mail Id
Reference (Please
provide
correct nos.)
Mobile no. is
also
mandatory
LAISHRAM DESIGNER 70857 88982 linlaishram248@gmail.com
LINTHOINGAMBI EXPORTS
CHANU
Employment & Education Verification Request Form
Current Employer (Not Renaura Wellness Pvt. Ltd.)
Designation/title DESIGNER
Department employed DESIGNING
Date of Employment From ……03/06/2023………………
To ……15/06/2023………………….
Employee code (if any)
Employer’s Company Name DESIGNER EXPORTS
Employer’s contact details SHRUTI DUGGAR
36E EAST TOPSIA
Address 1 KOLKATA
Address 2 WEST BENGAL
City 700039
State
Postal Code
Telephone number: 97345 68888
(Please provide correct nos.
with extension nos.)
Web - Site siddhant@designerexports.com
Compensation Details (Gross – 4.2 LPA
Annual Compensation
SHRUTI DUGGAR
Reporting HEAD DESIGNER
officer’s/supervisor’s
Name 97345 68888
Designation shruti@designerexports.com
Telephone No.
Telephone Extn. No.
Official e-mail address
Previous Employer
Designation/title
Department employed
Date of Employment
Employee code (if any)
Employer’s Company Name
Employer’s contact details
Address 1
Address 2
City
State
Postal Code
Country
Telephone number :
(Please provide correct nos.
with extension nos.)
Web - Site
Compensation Details (Gross –
Annual Compensation (mention
incentives / ESOP / bonuses as
separate components)
Reporting
officer’s/supervisor’s
Name
Designation
Telephone No.
Telephone Extn. No.
Official e-mail address
Education Verification Details (Highest Only)
Degree/Diploma
Institute NATIONAL INSTITUTE OF FASHION TECHNOLOGY , KOLKATA
Board / MINISTRY OF TEXTILE
University
Course / KNITWEAR DESIGN DEPARTMENT
Degree / Major
Year Of Passing 2019-2023
(From – To)
Grade / 8.5 CGPA
Percentage.
Please mention
Student roll no. BD/19/1225
Which is
mentioned in
your marks
card.
A copy of your education transcripts (certificate and mark sheet) must be attached to this form.
In connection with this request, I hereby authorize all corporations, former employers,
educational institutions, to release information about my background including but not
limited to information about my employment, education, , driving records, to the person
or company with which this form has been filed or their assigned agents thereof. My
signature, below releases the aforesaid parties or the company or the individuals releasing
the information from any liability whatsoever in collecting and disseminating the
information obtained. Further, I authorize the transmittal and release of information to
the above agencies and my employer in any country.
Applicant’s signature : Date: 24/09/2023________
Place: JAMSHEDPUR