Trainee Application Form

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EMPLOYMENT APPLICATION FORM

(Trainee Scheme)
Please fill up personal data from completely as we value this in our selection process
Name in Full (in Capital & underline Surname)
Please fill up the personal data form completely as we value this in our selection process.

Sex Marital Status Date of Birth Age (Yrs) Place of Birth

M/F

Language Speak Read Write

Nationality

Height (cm) Affix latest color photograph


Language known
(indicate (Passport size)
Weight (kg) whether Fluent,
Fair or poor and
Power of underline mother
Lens (if tongue)
relevant)

Blood Group

Physical Disability / major


illness
Present Address (In Block Letters) Permanent Address (In Block Letters)

Phone Number Phone Number


(Specify area code) (Specify area code)

Mobile Number E-Mail

Person to be contacted in case of Emergency (Name) Phone Number Relationship

Family Details (parents / brothers / sisters / spouse / children)


Resident of
Name Relationship Age Qualification Occupation (Company & designation)
(Location)

Are you willing to work any where in India? YES/ NO


Details
Please of Relatives
Indicate preferred working inreason
location with this company:
for the choice
Education Record (Starting with std. X & XII, Diploma /Degree year wise

Board/ Period Main % of


Examination/Degree Institution Subject/ marks
University
From To Specialization Grade
/div

Gaps in Education (if any):

Computer Literacy
Applications Expert Familiar Don’t Know
Word/Excel/Power point

CAD/CAM/Pro-E
ERP

MS DOS, WINDOWS 98, WINDOWS 2000 & WINDOWS XP


Others

Memberships
Professional Institutions Nature of Association

Social / Cultural / Political Organizations Nature of Association

Projects undertaken / Vocational Training


Period
Title of project Institute /Organization
From To
Achievements
What do you regard as the most significant achievement so far?

Extra Curricular Achievements


Activity Level Prices/Award Captainship/Position

Campus Life
Have you been a boarder at school or college? YES OR NO

If ‘yes’ indicate your major learning from your life in campus


Values and Beliefs
What are the beliefs and values that have guided your life so far and how do you see them
influencing your future?

Profile

Reflect on one significant person if any who has influenced your life so far. In which
way?

Also whether any author/book has influenced you?

Curricular Interest

Work Life Personal Life


Strengths and limitations

Strengths Limitation

Development

How will you ensure your continuous learning and development?

Medical Information
Do you have any medical problems or any illness issues or any kind of phobia? If Yes (Mention in
words)

Do you have any of following? If Yes (Tick on it)

BP/ Hypertension / Diabetes / Allergies / Asthma / Heart Problem

Chest Pain/ Thyroid


Education Plans

A. Do you have plan for higher education? YES OR NO

If ‘yes’ please give details and indicate what time frame you have in mind for the
same? (If you do not disclose these now and leave for higher studies during the
training the period you may be required to refund the stipend amount paid to you)

B. Have you already applied or intend to apply to any institute for higher studies?
YES OR NO

If ‘yes’ give details.

Note: Saying yes to any of the above does not rule out your selection into our training scheme.

Career Plans

What is your career plan?


Other Information

Any other information you would like to give.

Declaration
I certify that the foregoing information is correct and complete to the best of my knowledge and
belief. I am not aware of any circumstances, which might impair my fitness for employment. I
also do hereby authorize Piaggio to do Background Verification on me. If at any time, I am
found to have concealed any material information or given any false details, my appointment
shall be liable to summary termination without notice or compensation.

Place

Date
Signature of applicant

Human Resource

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