SOURCE :

MRF Limited, Corporate Office : 124, Greams Road, Chennai - 600 006.

POSITION APPLIED FOR

PERSONAL
PROFILE
NAME AGE (Yrs) DATE OF BIRTH

ADDRESS FOR COMMUNICATION NATIVE PLACE

IMPORTANT INSTRUCTIONS FOR
FILLING THIS FORM
STATE: STATE NATIONALITY
1. TO BE FILLED IN CANDIDATE'S
OWN HANDWRITING.
EMAIL ID PIN: RELIGION SC ST BC OTH 2. TICK MARK () WHEREVER
APPLICABLE.
MOBILE NO: PHONE WITH STD CODE HEIGHT (Cms) WEIGHT (Kgs) 3. GIVE COMPLETE DETAILS.
4. DO NOT ENCLOSE ORIGINAL
CERTIFICATES.
PERMANENT ADDRESS EYE SIGHT IF CORRECTED
5. AFFIX A RECENT PASSPORT SIZE
RIGHT LEFT
PHOTOGRAPH OF YOURS IN THIS
SPACE.
HANDICAPS IF ANY

STATE PIN:
IDENTIFICATION MARKS
1.
PAN NO. PHONE WITH STD CODE
2.

FAMILY BACKGROUND
RELATIONSHIP NAME DOB EDUCATION OCCUPATION ORGANISATION / PLACE

FATHER

MOTHER

BROTHERS /
SISTERS

SPOUSE
IF MARRIED
SON/S OF AGES DAUGHTER/S OF AGES
NUMBER OF CHILDREN

HAVE YOU ANY RELATIVES IN MRF? HAVE YOU ANY RELATIVES WORKING FOR TYRE COMPANIES,
IF YES, GIVE DETAILS OF NAME, DESIGNATION & TYRE DEALERS OR TYRE RETREADERS?
RELATIONSHIP IF YES, GIVE DETAILS OF NAME, DESIGNATION & RELATIONSHIP

ACADEMIC ACHIEVEMENTS Give details of all exams from school final onwards including Technical Qualifications (E.g. Type Writing)
DURATION MONTH & CLASS / MARKS
INSTITUTION UNIVERSITY / PRINCIPAL
QUALIFICATION YEAR OF GRADE / AGGRE-
WITH FULL ADDRESS BOARD SUBJECTS
FROM TO PASSING DIVISION GATE (%)

* State reasons for gaps if any.

EXTRA CURRICULAR ACTIVITIES / SPARE TIME INTERESTS
NATURE OF ACTIVITY LEVEL OF ACHIEVEMENT LANGUAGE / PROFICIENCY READ WRITE SPEAK
MOTHER TONGUE

WORK EXPERIENCE (State reasons for gaps, if any)

ORGANISATION / LOCATION (with Full Address) NATURE OF TRAINING / WORK FROM TO CTC PA

NAME & ADDRESSES OF REFERENCES (OTHER THAN RELATIVES)

1 2 3

WHY DO YOU CONSIDER YOURSELF SUITABLE FOR THE POSITION APPLIED? HAVE YOU BEEN INTERVIEWED FOR ANY
POSITION IN MRF? IF YES, GIVE DETAILS
OF POSITION AND APPROX. DATE

Expected CTC (P.A) JOINING TIME REQUIRED

DECLARATION
I hereby declare that the particulars as given above are true. Any false information contained in the application or
statement made before the Company's Medical Examiner, shall automatically rescind the contract of employment.

Date :
Place : Signature of Applicant

FOR MRF'S USE

PRELIMINARY INTERVIEW NOTES FINAL INTERVIEW NOTES DECISION

N226-M (3000-02/07) LIPTON