2012 01 25 new data form mbrdi
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This document contains a data form with personal and employment details. Part A includes sections for personal details, education history, employment history, and references. Part B includes fields for the position applied for, family details, languages known, training undergone, extracurricular activities, career goals, and expected salary details. The applicant provides authorization for Mercedes-Benz Research and Development India Private Limited to verify the information and conduct necessary background checks.
2012 01 25 new data form mbrdi
- 1. DATA FORM ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- PART A PERSONAL DETAILS Photograph Full Name (First/Middle/Last): Mobile Number: Alternate Number: Email ID: Nationality: Passport Number: Date of issue: Date of expiry: Social Security Number (If worked/studied in the US/Any other Country): Change of Name (if Applicable) Former Name/Maiden Name: Date of Name Change: Current Address: Permanent Address: City: City: Telephone: Pin code: Telephone: Pin code: Religion: Date & Place of birth: State of Domicile: th EDUCATION DETAILS (10 ONWARDS) Duration of Course Course Type Student ID No./ Course/ University/ School/College (Name, City, (Yrs.) Percent (Full time/Part Enrolment No./ Specialization Degree Board Pin code) age Time/ Seat No. From-To Correspondence) (MM/YYYY)
- 2. EMPLOYMENT DETAILS (Start from the current company) Where are you employed? Registered Corporate Office Branch Name of Company: Office Company Address (Where you are employed): Period of employment: (DD/MM/YY to Designation: DD/MM/YY): Department: Emp. Code: Employment Type: Permanent Total CTC: (Fixed + Variable) Temporary Contractual (Supervisor Name: Designation: Details) Email id: Landline: State your reason for leaving: Details of any existing service contract/bond: Previous Experience Name & Address of From To Gross Salary (Per Month) Position held Reason for leaving organization (MM/YYYY) Start Last Any gaps in education or employment? (If yes, please mention details with month and year): Details of two persons (excluding relatives) for reference: Name: Name: Address: Address: Occupation: Occupation: Contact No.: Contact No.: Email Id: Email Id:
- 3. PART B Post applied for: Department: Parents’ Name & Occupation: Siblings’ Name & Occupation: Marital Status: No. of Children & Age: Spouse Name, Profession & Nationality: Languages Known Speak Read Write Whether working with MBRDI: Particulars of relatives who are Directors or Employees of MBRDI (specify Particulars of previous Tests / Interviews with MBRDI (if any): relationship): Height: Weight: Blood Group: Vision Physical Disability (if any): Details of any major Left: Right: illness/accident/operation: TRAINING UNDERGONE Institution From To Stipend (if Training Contents any) Details of Extra Curricular Activities / Hobbies: Membership and office held in any organization / association including any professional body relevant to the job applied for:
- 4. Details of noteworthy work done and results achieved in the last three positions: Other facts (special skills / activities) relevant to the position applied for which have not been covered earlier: Career Goal: Break-up of minimum expected salary: Justification: Willingness to be transferred to any place on Company’s service (India or Time required to join: abroad): Yes No
- 5. Authorization/ Declaration and Undertaking If shortlisted by Mercedes-Benz Research and Development India Private Limited (MBRDI), I agree to provide self-attested copies of all relevant certificates as requested by MBRDI. I understand that employment with Mercedes-Benz Research and Development India Private Limited is governed by their employment policies and other applicable relevant guidelines, including satisfactory information from background checks. I hereby certify that all information provided herein, is true and complete to the best of my knowledge and belief. I authorize the HR department of Mercedes-Benz Research and Development India Private Limited to authenticate/share information that I have provided in my resume and various other documents and this Data Form by sharing it with various agencies for purely official purposes as deemed fit by MBRDI. I also authorize MBRDI or its partner agencies to conduct enquiries as may be necessary at the company’s discretion; I authorize all who may have information relevant to this enquiry to disclose it to Mercedes-Benz Research and Development India Private Limited and/or its representatives. I release all concerned from any liability on account of such disclosures. I also declare that the information provided by me in my resume and application for employment to Mercedes-Benz Research and Development India Private Limited and its representative is authentic and if any of this information is found to be false / incorrect, the Company would be free to terminate my services / cancel my selection / appointment or take any legal action deemed fit by MBRDI. I consent to extend total co-operation and provide relevant documents required. Full Name of the Candidate: ___________________________________________ Signature of the Candidate Current Location: ____________________________________________________ Date: ______________________________________________________________