Format No.: HRM/F/007/04 Reference SOP No.
: SOP/MHO/HR/004
INTERVIEW APPLICATION FORM
(To be filled by applicant in BLOCK letters)
Referred by: ________________________ Date: _________ Time: _________
Personal Details of Applicant:
Applicant’s Name: _____________________Post applied: ____at __________(HQ)__________Division
Qualification: __________ Date of Birth: (DD/MM/YYYY) ____________ Age: ____Year ____Month
Correspondence Address: _____________________________________________________________
____________________________________________________________ Pin code: ______________
Permanent Address: __________________________________________________________________
____________________________________________________________ Pin code: _______________
STD Code ________Tel. No. ___________ Mobile No. (1) ______________ (2) ___________________
Personal E-mail ID: ____________________________________________________________________
Details of Family:
Relations Qualification Profession Organization Town Residing Tel./Mobile No.
Father
Mother
Brother/Sister
Brother/Sister
Brother/Sister
Marital Status: Married: YES / NO
If YES, Name of Spouse: ____________________ Qualification: __________ Profession: ___________
No. of Children: ________ Son/s: _______ Age: ___________ Daughter/s: ________ Age: ________
Educational background of Children: 1 ______________ 2 _________________ 3 _________________
Do you possess 2 – Wheeler : YES/NO If YES, Model: ___________Vehicle. No._____________
Page 1 of 2
Format No.: HRM/F/007/04 Reference SOP No.: SOP/MHO/HR/004
Educational Details:
Month & Year % of Marks
Courses Stream Board / University / College
of Passing obtained
10th
12th
Graduation
PG
Details of Employments (Start from Present employment):
Date No. of
You
(DD/MM/YY) Segment/ Persons
Company Design. HQ Therapy
Report
Reporting to
CTC
From To To
You
Current Remuneration:
Current Monthly Salary: Rs._________. CTC: _______ Expected Monthly Salary: Rs._______. CTC: _______.
Current Daily Allowances: HQ: Rs._______ Ex HQ: Rs.______ OS: Rs.______ TA: ______ /Km
Sales Data:
Current Year YTD: Target: Rs. _______Lac, Achieved: Rs: _______Lac, % to Target: ____%, PCPM: _______
Previous Year YTD:Target: Rs. _______Lac, Achieved: Rs: _______Lac, % to Target: ____%, PCPM: _______
Note: Candidate is required to produce supporting for all the information furnished as above.
Signature of Applicant: _____________________________________ Date: __________________________
Page 2 of 2
Name: ___________________________
Position applied for: __________ Division: ______________ H.Q.:______________________
Details of field work (In case of experience candidate):
Last 3 Target Net Sales % Secondary Sales Dr. call Chemist call
months (Lac) (Lac) Achievement (Lac) average average
Details of Compensation: (Please attach last 3 months salary slip and supporting documents)
Components Per Month in Rs. Annual CTC
Basic
H.R.A.
Conveyance allowance
Vehicle allowance
KIT allowance
Supplementary allowance
City Compensatory allowance
L.T.A.
Bonus/ Ex- Gratia
Medical
Provident Fund (Co.
contribution)
E.S.I.
Gratuity
Others
Others
Others
Total CTC Per Month
Current Annual CTC:_____________PA, Expected CTC:_______________PA
Date:_____________ Signature
