INSTRUCTIONS FOR FILLING THE PERSONAL INFORMATION FORM:

Use Block / Capital Letters to fill this form.

PAGE I
1. Fill in your complete name.
2. Fill in your Father‘s / Husband’s complete Name.
3. Write your complete Address.
4. Residence contact number / landline number has to be given.
5. Personal Mobile number to be filled
6. Emergency Contact Number has to be given.
7. Date of Birth
8. Date of Joining
9. Pan No.
10. Personal Email id
11. Marital Status.
12. Date of Wedding, if married.
13. Nationality
14. ICICI Bank A/C. No. (if you have an ICICI Bank A/C)
15. One family photograph (for employees covered under ESIC)
16. Reference: How did you know about Kaya? Who forwarded you to Kaya?

PAGE II
1. Qualification Details
- Please give complete details about your Qualification (i.e., School / University, Degree ,
Date and Year of Passing, Percentage)

2. Previous Experience
- Complete Details about your previous employment have to be filled in (i.e., Exact Date
of Joining, Date of Relieving, Name of the Organisation, Designation, Compensation,
Reporting To )
PAGE III
1. Continuation of Previous Experience.

2. References: Atleast two references to be given with their contact numbers and Addresses.
(Referees should have been your supervisor / reporting manager in the past.
PAGE IV
1. Family Details:
- Complete Details about your family need to be filled.(i.e., Name , Relation, Date of Birth
and Occupation)
3. The fields in the second section are to be filled by Doctors/ Dieticians/ Physiotherapist and
Physical Trainers only.
- PAN No. has to be filled in
- Total number of hours in a week.
PAGE V
Checklist of Documents:
Please tick all the documents that you are submitting to us for our records.

*Please feel free to call Ms. Diksha for any further clarifications about the Form to be filled on
66195010.
First Name: ____________________________

Middle Name: __________________________

Last Name: ____________________________

Father/Husband’s Name: ____________________________________

Permanent Address: _______________________________________

_________________________Pin code: ________________

Tel (Resi):________________ Mobile: ___________________

Temperorary Address:_______________________________________

__________________________Pin code: _______________

Tel (Resi):________________ Mobile : ___________________

Date of Birth: _____________ Date of Joining : ________________

Personal Email id: __________________________________________

Marital Status: ______________ Date of Marriage: ____________

Nationality: __________________

ICICI Bank A/c. No.: ______________________

PAN CARD NO.: _________________________

BLOOD GROUP: ___________________

Emergency Contact Details:

Name of the Person:_________________________ Relationship:_______________

Contact Nos. : ________________________ Mobile: _________________________

 Where did you hear about Kaya Recruitment?

Newspaper Ads: _________________ Consultant: _______________

Someone working in Kaya: _____________ Kaya Recruitment Forms: Y/N

Kaya Jobs: ______________________ Others: ___________________

Qualification details:
School/Colle School/ Start Date End Date Percentage
ge/ Institute Degree/ & Year & Year
Name Institute Marks
University
with
Specialization

S.S.C

H.S.C

Graduation

Post
Graduation

Additional
Qualifications

Others
 Previous Experience:
Date of Date of Name of the Designation Compensation Reporting To
Joining Relieving Organization (Salary)
References (Previous Organisation or Professional):
Name of the Reference Contact No. Address of the reference/office

Family Details:
Name Relationship Date of Occupation
Birth
This page needs to be filled only by DOCTORS/DIETICIANS/ PHYSICAL
TRAINERS & PHYSIOTHERAPISTS WORKING FOR KAYA:

TOTAL NUMBER OFWORKING HOURS:

IN A WEEK DAYS FROM TO

REGISTRATION NO: ______________________________________

 CHECKLIST OF DOCUMENTS
(This Section needs to be filled on the day of Joining)

NAME: ______________________DESIGNATION:_________________

Sr. List of Documents to be submitted Tick on Any remarks for

No. submission non- submission
1. 3 Passport size Photographs.

2. Appointment Letter duly signed

3. Copy of Offer Letter duly signed.

4. Photocopies of Educational
Certificates (SSC/HSC/Graduation-
alongwith marksheets)
5. Photocopies of Post Graduation
Certificates (alongwith marksheets)
6. Photocopies of Additional
Qualification Certificates
7. Photocopies of Work
Experience/Appointment Letter/
Salary Slips Certificates.
8. Photocopy of Relieving Letter from
previous Organization.
9. Photocopy of Birth Certificate or
proof of age.
10. Photocopy of Residential Proof.

11. Letter if Certificates are not

submitted.
12. E.P.F. Nomination Form.

13. Family photograph (for ESIC

eligible members only)
14. 1 Postcard size personal photo (only
for SP’s)
15. Medical Reports

16. PAN Card Copy

I hereby abide to the Rules and Regulations of the Company.

Signature of the Joinee

Signature: __________________________