E - Form

EMPLOYMENT APPLICATION
LARSEN & TOUBRO LIMITED

POST APPLIED FOR .-Upstream Engineering ADVT REF
To be filld in by the applicant clearly and completely
( SURNAME ) HOW DO YOU PREFER YOUR NAME WITH INITIALS TO BE STATED IN WRITTEN COMMUNICATION ?
( FIRST NAME )
( MIDDLE NAME )
PRESENT HOME / MAILING ADDRESS / ADDRESS FOR COMMUNICATION
Please affix your recent Photograph
CITY PIN CODE EMAIL PERMANENT HOME ADDRESS
TEL NO. (with STD)
MOBILE NO CITY PIN CODE TEL NO BIRTH DATE RELIGION STATE OF DOMICILE CASTE ( DD/MM/YYYY ) SEX MARITAL STATUS NO. OF CHILDREN
AGE (Yrs) NATIONALITY BIRTH PLACE
PERSONAL DATA
NATIVE STATE FOR SCHEDULED CASTE/TRIBE
PERIOD OF STAY IN STATE WHERE RESIDING NOW ( YRs )
TYPE OF ACCOMMODATION ( Select appropriate option from the list )

Languages Speak Read
SUBCAST Monthly Rental / Charges Paid for Accommodation

Write
Rs.
LANGAGUES KNOWN ( Start with Mother Tounge)
FATHER'S NAME
AGE
DETAILS OF OCCUPATION (IF RETIRED, STATE LAST OCCUPATION)
DETAILS OF FAMILY MEMBERS (Please give full details of family members including parents, spouse, children and anyother dependents)
Name Age Relationship Occupation
EDUCATION DETAILS
FULL / PART TIME
Duration of Course
EXAMINATION PASSED
SPECIALISATION
SUBJECT
YRS MTHS
SCHOOL / COLLEGE INSTITUTION
NAME OF UNIVERSITY
DEGREE / GRADE DISTINCTIONS / YEAR OF DIPLOMA % SCHOLARSHIPS / PASSING CERTIFICATE MARKS PRIZES WON AWARDED
SSC or Equivalent School Leaving Certificate Intermediate or 12th Standard / HSC
MEMBERSHIP OF PROFESSIONAL INSTITUTE NAME OF INSTITUTE TYPE OF MEMBERSHIP AND POSITION HELD PERIOD DURATION OF MEMBERSHIP FROM TO
Post Grad. Degree / Diploma Certificate
DEGREE
DIPLOMA
Name of the Training Course Training
Duration
Year
Institute / Orgazination
Whether Certificate Awarded
TITLE Papers Published / Presented
NAME & DATE OF THE SEMINAR/JOURNAL IN WHICH PRESENTED / PUBLISHED
EXTRA CURRICULAR ACTIVITY (e.g. sports,social & Literary activities etc.)
ACTIVITY
INSTITUTION / ASSOCIATION SOCIETY / CLUB
YEAR
POSITION HELD
PRIZES WON
HEIGHT (cms)
WEIGHT (Kg)
POWER OF GLASSES
IDENTIFICATION MARKS
PHYSICAL DISABILITY IF ANY
HEALTH DATA
MOST RECENT SERIOUS ILLNESS
FROM
TO
NO. OF DAYS
NATURE OF ILLNESS
Do you or your spouse suffer from any of the following conditions/diseases 1. Diabetes 2. Cardiac 3. Asthma Have you ever been involved in any criminal proceedings / convicted of any offence ? CRIMINAL RECORD If yes, Please give details 4. High Blood Pressure 5. Other major illness/major operation & duration
III
WORK EXPERIENCE In unbroken chronological order starting from your first employment and ending with present employment (please account for all the periods of time not covered by education / training)
EMPLOYER'S NAME & ADDRESS (Please give Full address) DURATION
LAST POSITION HELD / DESIGNATION
NATURE OF DUTIES
From TO No. of Yrs . From

LAST POSITION HELD / DESIGNATION NAME & DESIGNATION OF IMMEDIATE SUPERVISOR
GROSS EMOLUMENTS (Rs. PER MONTH) AT THE TIME OF JOINING LAST DRAWN
AT THE TIME OF JOINING
TO No. of Yrs . From
NAME & DESIGNATION OF IMMEDIATE SUPERVISOR
LAST DRAWN
LAST DRAWN
LAST DRAWN
TO No. of Yrs .
LAST DRAWN
From
LAST DRAWN
TO No. of Yrs .
LAST DRAWN
DETAILS OF CURRENT EMOLUMENTS

EMOLUMENTS MONTHLY (Per Month)
PARTICULARS
YEARLY (Rs.)
Present (Rs. p.m.)
Expected (Rs. p.m.)
Proposed (to be filled by L&T)
BASIC DEARNESS ALLOWANCE OR EQUIVALENT HRA
MONTHLY EMOLUMENTS
CONVEYANCE (Do you own a Car / any other vehicle) CITY COMPENSATORY ALLOWANCE SALES COMMISSION / INCENTIVE EDUCATION ALLOWANCE ANY OTHER (Please Specify) i. ii. iii. SUB TOTAL (A) BONUS ( %) ON RS.
ANNUAL BENEFITS
LEAVE TRAVEL ASSISTANCE (LTA) ANY OTHER (Please Specify) i. ii. iii. SUB TOTAL (B)
RETIREMENT BENEFITS
PROVIDENT FUND ( BY EMPLOYER SUPERANNUATION GRATUITY SUB TOTAL (C)
%) CONTRIBUTION
GRAND TOTAL (A+B+C)

Medical Reimbursement Limit
HOSPITALIZATION
DOMICILLIARY
ANY OTHER (Please Specify)
Sr.No.
Particulars
Present
Proposed (to be filled in by Personnel Dept
OTHER PERQUISITES
VI
Draw in the brief organisation structure of the Company where you are presently employed indicating two levels above you and one level below your position. (Please also indicate the total number of persons under you).
SIGNIFICANT ACHIEVEMENTS : mention some of the major contributions made by you in your present and previous jobs :
EXPLAIN WHY YOU CONSIDER YOURSELF SUITED FOR THE POSITION
VII
Have you ever been interviewed by any of the L&T Group of Companies
If Yes, give details
Date/Year
Position
YES / NO Company
NAME
RELATIVES / ACQUAINTANCE IN L&T GROUP OF COMPANIES RELATIONSHIP POSITION
COMPANY
Who referred you to us ?
GENERAL DATA
Are you engaged in any Personal Business ? If yes, indicate nature of business
YES / NO
DO YOU HAVE ANY CONTRACT / BOND WITH YOUR PRESENT EMPLOYER If Yes, Please give details YES / NO
If selected, when can you join ?
1.
Name & addresses of Two references. (Not Relatives) 2.
DECLARATION UNDER SECTION 314 OF COMPANIES ACT, AS AMENDED IN 1974 ( Strike out whichever is not applicable ) I hereby declare that I am not connected with any of the Directors of the Company as his partner or his relative as defined under Section 6 of the Companies Act, 1956. OR I hereby declare that I am a partner or relative of Mr. A Director of the Company as .
I declare that the information given above is true to the best of my knowledge. I am aware that any false or incorrect information by me may result in termination of my services with the Company. I have no objection to your inquiring from any of my previous employers on any matters pertaining to me, if I join your Company
Place : Date :
Applicant's Signature

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EMPLOYMENT APPLICATION

LARSEN & TOUBRO LIMITED

To be filld in by the applicant clearly and completely

PRESENT HOME / MAILING ADDRESS / ADDRESS FOR COMMUNICATION

Please affix your recent Photograph

CITY PIN CODE EMAIL PERMANENT HOME ADDRESS

TEL NO. (with STD)

AGE (Yrs) NATIONALITY BIRTH PLACE

NATIVE STATE FOR SCHEDULED CASTE/TRIBE

PERIOD OF STAY IN STATE WHERE RESIDING NOW ( YRs )

TYPE OF ACCOMMODATION ( Select appropriate option from the list )

SUBCAST Monthly Rental / Charges Paid for Accommodation

LANGAGUES KNOWN ( Start with Mother Tounge)

DETAILS OF OCCUPATION (IF RETIRED, STATE LAST OCCUPATION)

SCHOOL / COLLEGE INSTITUTION

SSC or Equivalent School Leaving Certificate Intermediate or 12th Standard / HSC

Post Grad. Degree / Diploma Certificate

Name of the Training Course Training

Whether Certificate Awarded

TITLE Papers Published / Presented

NAME & DATE OF THE SEMINAR/JOURNAL IN WHICH PRESENTED / PUBLISHED

EXTRA CURRICULAR ACTIVITY (e.g. sports,social & Literary activities etc.)

INSTITUTION / ASSOCIATION SOCIETY / CLUB

PHYSICAL DISABILITY IF ANY

MOST RECENT SERIOUS ILLNESS

From TO No. of Yrs . From

AT THE TIME OF JOINING

TO No. of Yrs . From

NAME & DESIGNATION OF IMMEDIATE SUPERVISOR

LAST POSITION HELD / DESIGNATION

AT THE TIME OF JOINING

TO No. of Yrs . From

NAME & DESIGNATION OF IMMEDIATE SUPERVISOR

LAST POSITION HELD / DESIGNATION

AT THE TIME OF JOINING

TO No. of Yrs . From

NAME & DESIGNATION OF IMMEDIATE SUPERVISOR

LAST POSITION HELD / DESIGNATION

AT THE TIME OF JOINING

NAME & DESIGNATION OF IMMEDIATE SUPERVISOR

LAST POSITION HELD / DESIGNATION

AT THE TIME OF JOINING

TO No. of Yrs . From

NAME & DESIGNATION OF IMMEDIATE SUPERVISOR

LAST POSITION HELD / DESIGNATION

AT THE TIME OF JOINING

NAME & DESIGNATION OF IMMEDIATE SUPERVISOR

DETAILS OF CURRENT EMOLUMENTS

Present (Rs. p.m.)

Expected (Rs. p.m.)

Proposed (to be filled by L&T)

BASIC DEARNESS ALLOWANCE OR EQUIVALENT HRA

PROVIDENT FUND ( BY EMPLOYER SUPERANNUATION GRATUITY SUB TOTAL (C)

GRAND TOTAL (A+B+C)

ANY OTHER (Please Specify)

Proposed (to be filled in by Personnel Dept

EXPLAIN WHY YOU CONSIDER YOURSELF SUITED FOR THE POSITION

If Yes, give details

RELATIVES / ACQUAINTANCE IN L&T GROUP OF COMPANIES RELATIONSHIP POSITION