Form no: CU/HR/2024/1 CHITKARA UNIVERSITY

JOB APPLICATION FORM

To be filled by the HR Department (Post Joining) Paste a latest
passport.
1.EmployeeCode 2.Department Size photograph
here
3.Dateof Joining 4.School/College
(Do not pin)
5.Job Location 6.Designation
7.L1 Manager 8.L2Manager

To be filled in by the candidate (Use Blue Ball Pen Only)

1. POSITION APPLIED FOR:

2. NAME:

3. PRESENT ADDRESS:

4.PERMANENT ADDRESS:

5. MOBILE 6. ALTERNATE MOBILE NO.

7. EMAIL ID:

8. DATE OF BIRTH:

9: GENDER: MALE FEMALE OTHER

10. FAMILY DETAILS:(Please give details of Parents, Siblings, Spouse and Children, as applicable)
S.No. Name Age Relation Occupation

Note-No Column should be left blank.

Page1of5
11. MARITAL STATUS: MARRIED UNMARRIED DO NOT WANT TO DISCLOSE

12. IF MARRIED, DATE OF MARRIAGE:

13. AADHAAR NO.

14. PAN NO. 15. RELIGION

16. CATEGORY: GENERAL OBC SC ST

17. BLOOD GROUP: 18. PASSPORT NO.

19. EDUCATIONAL QUALIFICATIONS:

a) Highest Qualification to be written first.
b) Please attach the copy of all the educational certificates as mentioned below.

Year Name of Grade/Division/ Part Time/Full

Qualification Passed School/College/University Percentage Specialization
Time

20.EMPLOYMENT DETAILS:
a) Please use extra sheet if required.
b) Please attach the copy of experience certificates as mentioned below.

TOTAL EXPERIENCE: (Years & Months)

Current/Last Employment
Current/Last
Name & address of
From To Designation CTC (Rs. Per Reason for leaving
present/last employer
annum)

Employment History
Names and Address of
CTC
Previous Employers From To Designation Reason for leaving
S.No. (Rs. Per annum)

Page2of5
 Employment History (Contd.)

Names and Address of CTC

Previous Employers From To Designation Reason for leaving
S.No. (Rs. Per annum)

Total no. of job changes:

20. Have you been at a career break at any time? If yes, please specify the period and reason.
Yes No

21. Present Emoluments (Please give the break-up of present salary)

1. Grade 8. Provident Fund
2. Basic Salary 9. Bonus
3. Dearness Allowance 10. Gratuity
4. House Rent 11. Pension
5. Conveyance 12. Any other benefit
6. Medical Assistance
7. Any other allowance

22. Please provide the details of the Universal Account Number (if applicable) & ESIC number (if applicable)

UAN

ESIC

23. PROFESSIONAL REFERENCES (Please give two references preferably your past reporting managers)

S.No Name Designation Company Name Contact Email Id: Reporting

& Address Number Relationship

Page3of5
24.
Why do you consider yourself suitable for the job applied?

25. Does any of your relative/known work with any of the Institutes of Chitkara Educational Trust?
Yes No
If yes, please fill the following details.
Name of the Institute:(Please tick one of the following)

Chitkara University, Punjab Chitkara International School

Chitkara University, Himachal Pradesh Head Office,Chandigarh
Other, please specify:
Name of the Relative/Known: Relation:
Department: Designation:
Working Since: Contact Number:

26. Have you been interviewed by us before? If yes, then please specify the date and position for which
you were Interviewed.

27. Have you been employed with any of the Institutes of Chitkara Educational Trust before?
Yes No
If yes, please fill the following details:

Prev. Employee Code: Department:

Date of Joining: Date of Exit:
Designation at the time of
leaving

28. Any major illness in the past two years. If yes, please provide details:

29. Do you have any physical disabilities/allergies? If yes, please provide details:

30. Is there any criminal/civil proceedings/warrant/summons/pending against you? If yes, please

provide details:

Page4of5
31. Please mention your hobbies/other interests:

1.

2.

3.

32. Whom to contact, in case of EMERGENCY

Name: Relationship:
Alternate Contact
Mobile Number:
No.
Address

33. Expected Salary .................................................... (per month)

34. Duration of Notice Period to be served: ……………...............................

35. Any other information you would like to furnish:

DECLARATION:

I shall, when required, take up casual/temporary/permanent duty in discharge of university or its

associate companies, assignments, anywhere in India or abroad.
I hereby declare that all information contained in this form is true and to the best of my knowledge. I
understand that, if any of the contents/information furnished herein are found to be false, my
candidature shall not be pursued/my services shall be terminated.

Place: …………………………
Date: …………………………. Signature ……………………………

Page5of5