Gamana

# 201, Gayathri Millennium Enclave, Lane opp to Image Hospital Bus Stop, Opp to
Dena Bank, Arunodaya Colony, Madhapur, Hyd’Bad-81 (Ph-23100219)

PERSONAL INFORMATION SHEET (PIS)

(PLEASE FILL THE BOXES WITH GREEN WHERE APPROPRIATE)

A. ARE YOU SINCERE IN YOUR SELF ASSESSMENT? YES NO

B. ARE YOU HARD WORKING? YES NO

C. DO YOU MAINTAIN NEATNESS AT YOUR WORK PLACE? YES NO

D. DO YOU TAKE RISKS IN YOUR JOB PERFORMANCE? YES NO

E. ARE YOU READY TO MAKE SACRIFICES FOR OTHERS? YES NO

F. ARE YOU WILLING TO TAKE “OATH OF OFFICE”? YES NO

G. ARE YOU NON SMOKING/NON CHEWING AT OFFICE? YES NO

H. ARE YOU READY TO WORK ANYWHERE IN A.P? YES NO

I. WILLING TO PURSUE FURTHER STUDIES IN FUTURE: YES NO

J. WILLING TO GIVE AGREEMENT FOR TWO YEARS: YES NO

(WARNING: If the answer is YES to all the above then only go down to fill this PIS.
Otherwise don’t bother to look for opportunities in Gamana).

K. YOU ARE FAITHFUL TO: a) BHAGAVAD GITA b) QURAN

c) BIBLE d) YOUR OWN CONSCIENCE

L. YOUR WORSHIPPING GOD/GODDESS IS:_____________

M. HOW MANY HOURS OF VOLUNTEER WORK YOU CAN

CONTRIBUTE EVERY WEEK TO THE SOCIETY APART FROM THIS
JOB:______

N. HAVE YOU INFORMED YOUR PRESENT ORGANIZATION ABOUT

LEAVING THE ORGANIZATION?

a) YES b) NO c) NA
1. NAME OF THE POST APPLIED FOR:______
2. NAME:(In capitals)

3. ADDRESS FOR CORRESPONDANCE:

(i). FATHER/HUSBAND NAME :
(ii) HOUSE No :
(iii) STREET/LOCALITY NAME :
(iv)VILLAGE/TOWN :
(v) MANDAL :
(vi) DISTRICT :
(vii) PIN CODE :
(viii) LAND LINE NUMBER :
(ix) MOBILE NUMBER :
(x) E MAIL ID :

4. PERMANENT ADDRESS:
(i). FATHER/HUSBAND NAME :
(ii) HOUSE No :
(iii) STREET/LOCALITY NAME :
(iv)VILLAGE/TOWN :
(v) MANDAL :
(vi) DISTRICT :
(vii) PIN CODE :
(viii) LAND LINE NUMBER :
(ix) LOCAL MOBILE NUMBER :

5. DATE OF BIRTH: D D M M Y Y Y Y

1. AGE GROUP: 21 TO 30 PLEASE INSERT

SOFT COPY OF
2. AGE GROUP: 31 TO 40 YOUR PASSPORT
PHOTOGRAPH
3. AGE GROUP: 41 TO 50 HERE

6. MARITAL STATUS:
(1) MARRIED

(2) UNMARRIED

7. EDUCATIONAL QUALIFICATIONS: STARTING FROM 10TH CLASS :

S# Year Education Institution Class Percentage
%
1

5. PROFESSIONAL QUALIFICATIONS, IF ANY

S# Year Education Institution Class

1
2

5. EXPERIENCE: STARTING FROM LATEST

S# Organization/ Period No. of Name Field/ Contact Salary
Institution Months of the Subject Person Drawn
Post with
mobile
no.
From To
1

7. TRAININGS ATTENDED:
S# Month & Duration Subject Title of the GIVEN BY
Year (Days) Training
1

8. KNOWLEDGE LEVELS:
 Poor Average Good Very good Excellent
Activities 1 2 3 4 5
Environmental Issues
Water and Sanitation
HIV/AIDS
Education
Health
Tribal Affairs
RTI Act
Gender
Livelihoods
Accounts
Legal

9. KNOWLEDGE OF ENGLISH:
Poor Average Good Very good Excellent
English Skills 1 2 3 4 5
Writing

Writing & Understanding

Writing, Understanding
Speaking

10. DO YOU THINK YOU REQUIRE ENGLISH COACHING:

(1) YES

(2) NO

11. ARE YOU WILLING TO JOIN SPOKEN ENGLISH CLASSES:

(1) NO

(2) YES

(3) NOT APPLICABLE

12. IF YES, DO YOU WANT THE ORGANIZATION TO PAY YOUR SPOKEN
ENGLISH COURSE FEE:

(1) YES

(2) NO
 (3) NOT APPLICABLE

13. TIME REQUIED FOR LEARNING ENGLISH LAUNGUAGE SKILLS:

(1) 6 MONTHS

(2) 5 MONTHS

(3) 4 MONTHS

(4) 3 MONTHS

(5) 2 MONTHS

(6) NOT APPLICABLE

14. COMPUTER SKILLS:

Poor Average Good Very good Excellent

Computer Skills 1 2 3 4 5

MS Word

MS Excel

MS Power Point

15. DO YOU THINK YOU REQUIRE COMPUTER COACHING?

(1) YES

(2) NO

(3) NOT APPLICABLE

16. ARE YOU WILLING TO JOIN COMPUTER CLASSES?

(1) NO

(2) YES

(3) NOT APPLICABLE

17. IF YES, DO YOU WANT THE ORGANIZATION TO PAY YOUR

COMPUTER COURSE FEE:
 (1) YES

(2) NO

(3) NOT APPLICABLE

18. TIME REQUIED FOR LEARNING COMPUTER KNOWLEDGE:

(1) 6 MONTHS

(2) 5 MONTHS

(3) 4 MONTHS

(4) 3 MONTHS

(5) 2 MONTHS

(6) NOT APPLICABLE

19. DRIVING SKILLS:

(1) TWO WHEELER

(2) FOUR WHEELER

20. DRIVING EXPERIENCE:

(1) ONE YEAR

(2) TWO YEARS
(3) THREE YEARS
(4) MORE THAN 3 YEARS

21. DO YOU HAVE DRIVING LICENSE (IF YES, PL. SEND PHOTOCOPY):

(1) NO

(2) YES

22. DO YOU HAVE BANK ACCOUNT:

(1) NO
 (2) YES

(IF YES PLEASE FILL THE TABLE AND PLEASE SEND ATM SLIP)
IS THE
BRANCH & ACCOUNT
S# NAME OF THE BANK BANK
ADDRESS NUMBER
ONLINE

23. YOU HAVE: (PLEASE SEND PHOTOCOPIES)

(1) RATION CARD YES NO

(2) VOTER ID CARD YES NO
(3) PAN CARD YES NO
(4) PASSPORT YES NO

24. IF YOU ARE WILLING TO PURSUE & COMMIT FOR FURTHER STUDIES
IN FUTURE, WHAT IS THE PROPOSED COURSE: ___________

25. WILLING TO BE A PERMANENT EMPLOYEE TO BE ELIGIBLE FOR

THE BENEFITS OF PROVIDENT FUND, INSURANCE COVERAGE,
PROMOTIONS, PROJECT ELEVATIONS, INCREMENTS, REWARDS,
BONUS, OPPORTUNITY OF ATTENDING INTERNATIONAL TRAINING
PROGRAMS OR JUST TO BE A TEMPORARY AND PROJECT BASED
EMPLOYEE WITHOUT ANY OF THE ABOVE BENEFITS?

(1) TEMPORARY EMPLOYEE

(2) PROJECT BASED EMPLOYEE

(3) PERMANENT EMPLOYEE

26. WILLING TO BECOME A COMMITTEE MEMBER:

(1) NO

(2) YES.

IF YES, IN THE COMMITTEES* OF

(i) HRDC
(ii) DPC
(iii) MAINTENANCE
(iv) SWF
 (v) PIC
(vi) PURCHASE

27. EXPECTED MONTHLY SALARY

IN THE YEAR -2010: Rs………….

IN THE YEAR -2011: Rs…………

IN THE YEAR- 2012: Rs………….

IN THE YEAR-2013: Rs……………

IN THE YEAR-2015: Rs……………

30. DETAILS OF DEPENDANTS IF ANY:

A. PARENTS:

(1) NO

(2) YES

B. UN MARRIED BROTHERS:

(1)NO

(2) YES

B. (2).i. IF YES, HOW MANY:

C. UNMARRIED SISTERS:

(1) NO

(2) YES

C.(2). i. IF YES, HOW MANY:

(D) PERSONAL FAMILY

(1) WIFE

D. (1).i NA
 (2) CHILDREN

D. (2).i GIRLS

D. (2).ii. BOYS

D. (2).iii. NA

(E) ANY OTHER DEPENDANTS

(1) NO

(2) YES

E. (2).i. IF YES, WHO…………………..

31. NGO FIELD/JOB/WORK IS PREFERRED/OPTED BY YOU BECAUSE:

FOR (1) SALARY

(2) CAREER

(3) SOCIAL SERVICE MOTIVE

32. YOU HAVE BEEN REFERRED/CAME TO GAMANA THROUGH

1. Devnet Advertisement

2. Web Site

3. Friend

4. Staff

(Give Name & Office :……………………………………………………..…….)

33. WHAT IS YOUR BLOOD GROUP:……………………

34. THIS PIS WAS FILLED BY a) ME ONLY b) MY FRIEND

***********************************************************************
*
FOR OFFICIAL USE ONLY:
(1) MARKS IN ENGLISH TEST
(2) MARKS IN COMPUTER SKILLS TEST
 (3) MARKS IN SUBJECT MATTER/EXPERIENCE TEST
(4) BEHAVIOR PATTERN
(5) COMMUNICATION SKILLS
(6) LEADERSHIP QUALITIES
(7) FEED BACK FROM CONTACT PERSONS
HRDC=Human Resources Development Committee
DPC= Disciplinary Proceedings Committee
SWC=Staff Welfare Committee
PIC= Program Implementation Committee
MC = Maintenance Committee

P.S: Please send this PIS to the following E mail Ids

1. anildayakar@gmail.com
2. cherukurilaxmi@gmail.com
3. gamana.hrd@gmail.com