Please

Affix
Your
INFOSYS TECHNOLOGIES LIMITED
Electronics City, Hosur Road, Bangalore - 560 100, India. Passport
Tel.: (080) 28520261-270. Fax: (080) 28520362. Photo Here

APPLICATION FOR EMPLOYMENT

01. Please answer each column fully and neatly in your own handwriting.
02. Please ü in the wherever applicable.

Interview Location................................................................

NAME IN FULL
(in block letters) ................................................................................................................................................................................
FIRST MIDDLE SURNAME

PERMANENT ADDRESS ADDRESS FOR COMMUNICATION

....................................................................................................... ..................................................................................................
PERSONAL DETAILS

.................................................................................................. ..................................................................................................

.................................................................................................. ..................................................................................................

.................................................................................................. Day Time Contact No. ..................................................... (Optional)

.................................................................................................. Mobile No. ................................................................................

Tel. No. (Specify area code).................................................................... e-mail: ......................................................................................

DATE OF BIRTH : AGE : PLACE OF BIRTH : DOMICILE OF (STATE IN INDIA) :

(dd/mm/yyyy)
CITY : ..........................................
.......................................... .................. COUNTRY : .................................. .............................................................

CITIZENSHIP(S) :
SEX : MALE FEMALE
...............................................................................................

RELATIONSHIP NAME OCCUPATION ADDRESS

PARTICULARS

FATHER/
FAMILY

GUARDIAN

MOTHER

SPOUSE

BLOOD GROUP : ALLERGIES, IF ANY ...............................................................................................

.................................... .................................................................................................................................
HEALTH

LAST MAJOR ILLNESS/SURGERY

(Specify Date)

VISION : LEFT RIGHT ..............................................................................................................

...............................................................................................................

....................................................................................................................

VER 07.00 1 of 5 HRD/REC/E/011

 DO YOU HAVE A PASSPORT? YES NO IF YES, PLEASE FILL IN THE PARTICULARS
PASSPORT DETAILS
PASSPORT NO. : DATE OF ISSUE : VALID UPTO : ISSUED BY : PLACE :
........................................ ........................................ ........................................ ........................................ ........................................

ADDRESS IN PASSPORT : EMIGRATION CHECK REQD. : YES NO

....................................................................................................
IN CASE YOU HAVE ONLY APPLIED FOR PASSPORT,
......................................................................................................
.............................................................................................. DATE OF APPLICATION : ..................................................

.............................................................................................. TO WHOM : ......................................................................

XII STD/DIP./EQUIV.* POST

LEVEL** X STD* GRADUATION* OTHERS*
GRADUATION*

NAME OF THE
QUALIFICATION AWARDED

BOARD /
UNIVERSITY

SCHOOL /
COLLEGE

AREA OF
SPECIALIZATION

YEAR & MONTH OF

FINAL EXAMINATION

TOTAL AGGREGATE
MARKS SCORED FOR ALL
SUBJECTS / SEMESTERS /
EDUCATION

YEARS

MAX. MARKS FOR ALL

SUBJECTS / SEMESTERS /
YEARS

SIMPLE AVERAGE
PERCENTAGE / CGPA /
GRADE FOR ALL YOUR
SUBJECTS / SEMESTERS

POSITION/RANK IN
THE CLASS
*ALL PERCENTAGES / CGPA SHOULD BE SIMPLE AVERAGE FOR ALL YOUR SUBJECTS / SEMESTERS / YEARS.
**ALL INFORMATION PROVIDED WOULD BE VALIDATED AT THE TIME OF JOINING, IF AN OFFER IS MADE.

GAPS IN EDUCATION (If any) ..................................................................................................................................................

SCHOLASTIC ACHIEVEMENTS (Ranks, Merit Scholarships, Prizes, etc.) ..............................................................................

..............................................................................................................................................................................................................................
..............................................................................................................................................................................................................................

EXTRA CURRICULAR ACTIVITIES...........................................................................................................................................

.........................................................................................................................................................................................................
.........................................................................................................................................................................................................
MOTHER TONGUE : ................................................. PROFICIENCY
Can Can Can Can
LANGUAGE (Please highlight foreign languages) Understand Speak Read Write
LANGUAGES

VER 07.00 2 of 5 HRD/REC/E/011

 PLEASE WRITE ‘NA’ IF NOT APPLICABLE.
Specify clearly in case of part time/contract work experience. Notice period required.......................................
PERIOD (MM/YYYY)
ORGANIZATION DESIGNATION MAJOR REASON FOR
FROM TO DURATION RESPONSIBILITIES SEPARATION
(in months)
WORK EXPERIENCE
(For Software Professionals)

HARDWARE PLATFORMS WORKED ON :

TECH. SKILLS PROFILE

...........................................................................................................................

OPERATING SYSTEMS / DATABASES USED :

....................................................................................................................

LANGUAGES & TOOLS FAMILIAR WITH :

..........................................................................................................................

LIST THREE PROFESSIONAL REFERENCES (not related)

SL. NO. NAME & ADDRESS OCCUPATION EMAIL TEL. NO.

01.
REFERENCES

02.

03.

VER 07.00 3 of 5 HRD/REC/E/011

 DO YOU KNOW ANYONE WORKING AT INFOSYS PRESENTLY? YES NO
IF YES, PLEASE LIST THEM BELOW

NAME RELATIONSHIP DESIGNATION

REFERENCES

..........................................................................................................................................................................................................

CONTACT PERSON IN CASE OF EMERGENCY :

NAME & ADDRESS TEL. NO. (EVEN P. P.) RELATIONSHIP

NEXT REVISION EXPECTED YOUR EXPECTATION AT

COMPENSATION** CURRENT IN YOUR PRESENT JOB INFOSYS
DATE:................................

1. MONTHLY
Basic .......................................................................................................................................................................................
HRA .........................................................................................................................................................................................
Dearness Allowance ...............................................................................................................................................................
Conveyance Allowance/
Reimbursement ........................................................................................................................................................................
Professional Journals ..............................................................................................................................................................
Education Allowance ..............................................................................................................................................................
COMPENSATION

Other Monthly Allowance ........................................................................................................................................................

SUB TOTAL (A)
2. ANNUAL
LTA ..........................................................................................................................................................................................
Medical Reimbursement ...........................................................................................................................................................
Bonus/Ex-gratia .......................................................................................................................................................................
Other Annual Benefits .............................................................................................................................................................
SUB TOTAL (B)
3. RETIREMENT BENEFITS
Provident Fund ........................................................................................................................................................................
Gratuity ...................................................................................................................................................................................
Superannuation .......................................................................................................................................................................
SUB TOTAL (C)

GRAND TOTAL (A+B+C)

LOANS : Amount Eligible % Interest ESOP’s : Numbers

BENEFITS

Issue Price
Housing
4 Wheeler Others :
Other

**ALL INFORMATION PROVIDED WOULD BE VALIDATED AT THE TIME OF JOINING, IF AN OFFER IS MADE.

VER 07.00 4 of 5 HRD/REC/E/011

 HAVE YOU UNDERGONE ANY SELECTION PROCESS WITH INFOSYS OR INFOSYS GROUP NO YES
COMPANIES (LIKE PROGEON, ETC.) PREVIOUSLY ?

IF YES, HAVE YOU INFOSYS OTHER GROUP COMPANIES

RELEVANT DATES RELEVANT DATES
- TAKEN ANY TEST ? NO YES NO YES
......................... .........................
- BEEN SELECTED FOR INTERVIEW ? NO YES NO YES
......................... .........................
- BEEN MADE AN OFFER ? NO YES NO YES
......................... .........................

ARE YOU EMPLOYED AS : A. A DIRECTOR IN ANY OTHER COMPANY? NO YES

B. A PARTNER IN ANY FIRM ? NO YES

IF YES, PLEASE MENTION DETAILS OF THE SAME :...................................................................................................................

................................................................................................................................................................................................................
MISCELLANEOUS

ARE YOU UNDER ANY LEGAL OBLIGATION TO YOUR CURRENT EMPLOYER?

YES NO
IF YES, PLEASE CLARIFY :........................................................................................................................................................
...................................................................................................................................................................................................

ARE YOU CURRENTLY EMPLOYED WITH ANY OF THE INFOSYS GROUP COMPANIES ?
IF YES, PROGEON OTHERS Please Specify .......................................................................................
Have you at any time been convicted by a court of India for any criminal offence and sen-
tenced to imprisonment, or any criminal proceedings are pending against you before a court YES NO
in India, or an order prohibiting your departure from India has been issued by a court,
If yes, please give details of the same...................................................................................................................................................
.........................................................................................................................................................................................................
.........................................................................................................................................................................................................
DECLARATION
I certify that the above statements made by me are true, complete and correct. All the academic marks / percentages / CGPA
are simple average for all subjects / semesters / years. I agree that in case the company finds at any time that the information
given by me in this form is not correct, true or complete, the company will have the right to withdraw my letter of appointment
or to terminate my appointment at any time without notice or compensation.

Place : .......................................

Date : ......................................... Signature: ..............................................................

LOCATION PREFERENCE
Date of Test :......................... Date of Interview :............................
1) ...........................................................................
Score :.......................... Written Test Ref. No. :...............................
FOR OFFICE USE ONLY

Panel & Employee No. :................................................................... 2) ...........................................................................

....................................................................................................... 3) ...........................................................................

Result : Selected Hold Rejected (Please ü )

Role :................Personal Band (if any) :.......................Job Band :.................. Location : ......................................................

Proposed Basic :............................ Likely Joining Date : ........................ Training Requirement : YES NO
(MM/YYYY)
Special Allowance : ........................ Duration of Training : ..................................

Reason for Selection/Rejection : ..................................................................................................................................................

..........................................................................................................................................................................................................
..........................................................................................................................................................................................................

VER 07.00 5 of 5 HRD/REC/E/011