.

Glen Rose

Affix Self-Attested
Photograph

Petroleum Corporation
1210 w clay street # 5 Houston,
TX 77019 USA
career@glenrose-petroleum.com
Hr Contact: +15304365340

Application and Interview form

Application for the Post of: _________________________________________________________________

PERSONAL DETAILS:
Full name in block letters
First name

Surname

Age

Nationality

Date of birth

Category

Second name

Place of birth with state

Gender
M/F

Marital Status

Passport Number

Physically
Challenged
YES / NO

Address for correspondence:

(in block letters )

Phone No:

E-mail:

ACADEMIC DETAILS:

Page 1 of 3

.
Qualification

College, University,
Institution

Examination Passed
/ Appeared

Year of
passing

Division, Percentage
of Marks etc.

Matriculation
(10th std.)
Higher
(+2)
Secondary
Graduation
PG
Other
Qualification

OTHER INFORMATIONS:
Family Background

Any Certificate Awarded

WORK EXPERIENCE (if any):

Total Length of Service

Years:

Date
From

To

Name and Address of

Organization

Reason For Joining With Us

Months:

Detail of position/grade/
responsibilities etc

Present
Salary

Time required for joining, if selected:

Skype Id for oral interview (if any):

Page 2 of 3

.
Time available on Skype :
I hereby certify that the information provided above is true to the best of my knowledge and in
case any information as above is found to be false or in-correct or suppressed at any stage, I
understand that I am liable to be terminated from the services of GLEN ROSE PETROLEUM
CORPORATION, USA forthwith without prejudice to any other legal and disciplinary action as
deemed fit by the Management.

Date:.
(Signature of Applicant)

Page 3 of 3