Maintec Technologies Private Limited

APPLICATION FORM

Please fill in the details with utmost attention, as these shall be verified by Maintec Technologies Private Limited. And / or by its authorized
representatives.

All details are compulsory. Please Affix

Your
Passport
Size
PERSONAL DETAILS Photograph
Name of Applicant: Surname Middle First

Date of Birth (dd/mm/yy): Place of Birth:

Sex: Nationality:

Father’s Name: Passport No/National ID Number.:

Home Phone: Office Phone: Mobile:

RESIDENTIAL ADDRESSES : ( PLEASE WRITE RECORD OF SEVEN YEAR LAST SEVEN YEAR ADDRESS DETAIL IN ASCENDING ORDER )

ADDRESS 1:

City: State:

Pin: Phone No.:

Duration of Stay: From (mm/yy) To (mm/yy) Nature of location: Rented Own Other (Specify)

ADDRESS 2:

City: State:

Pin: Phone No.:

Duration of Stay: From (mm/yy) To (mm/yy) Nature of location: Rented Own Other (Specify)

ADDRESS 3:

City: State:

Pin: Phone No.:

Duration of Stay: From (mm/yy) To (mm/yy) Nature of location: Rented Own Other (Specify)

All fields are mandatory Strictly Private & Confidential

 Maintec Technologies Private Limited

EDUCATION DETAILS

DATES ATTENDED
COURSE
NAME & NAME & ADDRESS OF
ATTENDED MARKS (%) YEAR ROLL NUMBER/
ADDRESS OF BOARD / UNIVERSITY
(MORNING/ CGPA OF REGISTRATION
QUALIFICATION SCHOOL / TO WHICH THE SCHOOL / YEAR
EVENING/ & ENROL NUMBER/ EXAM
COLLEGE/ COLLEGE / INSTITUTE PASSED
CORRESPONDEN CLASS MENT SEAT NUMBER
INSTITUTE IS AFFILIATED TO (MM/YY)
CE) (MM/Y
Y)
GRADUATION

DEGREE:

DISCIPLINE:

POST GRADUATION

DEGREE:

DISCIPLINE:

ANY OTHER

REASONS FOR BREAKS IN EDUCATION: ______________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

All fields are mandatory Strictly Private & Confidential

 Maintec Technologies Private Limited
EMPLOYMENT RECORD: Starting with your present or most recent employer, please list last 3 employments. When listing consulting or temporary
assignments, under “Employer”, state the name of the consulting or temporary agency that placed you at the client site. Complete and accurate
dates (month/year) must be provided.
CURRENT EMPLOYER: Employee Id: From (mm/yy): To (mm/yy):

Street Address: Employer’s Fax No.:

Phone No.:

City: State: Country: Postal Code:

Job Title: Reason for Leaving:

Employment Status: (Please check the relevant box) Supervisor’s Details:

Full Time Name:
Contract /Through Outsourcing Agency
Title:
Outsourcing Agency Details: Phone No.:
Name:
Address: E-mail id:
(Preferably official)
Tel No.: HR Manager’s Details:
Name:
Description of Duties: Phone No.:
E-mail id:
(Preferably official)

EMPLOYER 1: Employee Id: From (mm/yy): To (mm/yy):

Street Address: Employer’s Fax No.:

Phone No.:

City: State: Country: Postal Code:

Job Title: Reason for Leaving:

Employment Status: (Please check the relevant box) Supervisor’s Details:

Full Time Name:
Contract /Through Outsourcing Agency
Title:
Outsourcing Agency Details: Phone No.:
Name:
Address: E-mail id:
(Preferably official)
Tel No.: HR Manager’s Details:
Name:
Description of Duties: Phone No.:
E-mail id:
(Preferably official)

All fields are mandatory Strictly Private & Confidential

 Maintec Technologies Private Limited
EMPLOYMENT RECORD CONTINUED:
EMPLOYER 2: Employee Id: From (mm/yy): To (mm/yy):

Street Address: Employer’s Fax No.:

Phone No.:

City: State: Country: Postal Code:

Job Title: Reason for Leaving:

Employment Status: (Please check the relevant box) Supervisor’s Details:

Full Time Name:
Contract /Through Outsourcing Agency
Title:
Outsourcing Agency Details: Phone No.:
Name:
Address: E-mail id:
(Preferably official)
Tel No.: HR Manager’s Details:
Name:
Description of Duties: Phone No.:
E-mail id:
(Preferably official)

REASONS FOR BREAKS IN EMPLOYMENT HISTORY: ______________________________________________

____________________________________________________________________________________________

PROFESSIONAL REFERENCES:

PARTICULARS REFERENCE 1 REFERENCE 2 REFERENCE 3

NAME

Organization

Designation/Position

Landline No.

Mobile No.

Email Address

All fields are mandatory Strictly Private & Confidential

 Maintec Technologies Private Limited
INFORMATION RELEASE AUTHORIZATION

I certify that the statements made in this application are valid and complete to the best of my knowledge. I understand that false or misleading information
may disqualify me from employment and /or result in termination of employment.

I understand that Maintec Technologies Private Limited may request a verification of information provided by me and /or background check from an
agency hired by Maintec Technologies Private Limited for this purpose.

I further understand that the results of verification and checks and any records made out of that information will be used for employment purposes only and
will not be given to unauthorized persons.

I authorize Maintec Technologies Private Limited and/or its agents Pinkerton Corporate Risk Management India Pvt Ltd. to conduct a verification and
background check including but not limited to the verification and check of information and references stated by me in this application for the consideration
of Maintec Technologies Private Limited be used only for my employment purposes.

I also authorize all the concerned persons, authorities, organizations, their employees, agents or authorized representatives, whether named in the application
or not, to release the information in their knowledge / possession / records relevant to my employment.

In the event that Maintec Technologies Private Limited and /or its agents are unable to verify any information and references stated in this application, it
is my responsibility to furnish the necessary documentation in support of that information.

“I fully understand that my personal information would move out of the geographical boundaries of the country I am a resident of, in order to carry on with
my verification process”.

I fully understand that this application or subsequent employment does not create a contract of employment nor guarantee employment for any definite
period of time and my employment decision will always be at the sole discretion of Maintec Technologies Private Limited

I have read, understood, and by my signature consent to these statements.

I authorize Maintec Technologies Private Limited to contact my present employer. Yes No

SIGNATURE:
DATE:
NAME (IN BLOCK LETTERS):

All fields are mandatory Strictly Private & Confidential