VER 1C 1 of 2 HRD/REC/F/013

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Maharaja Surajmal Institute of Technology

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IndianCountry : India Pin Code : 110054

CITY : New Delhi

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WZ-353,Street No. 2 Virender Nagar

City : New delhi State : Delhi

gaurshivam93@gmail.com Alternate Contact Number :

Preferred Contact Number : 9811520121

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NAME IN FULL (In Block Letters) SHIVAM ........................................................................................................................

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INFOSYS LIMITED Electronics City, Hosur Road,Bangalore - 560 100,India.

Tel.: (080) 28520261. Fax: (080) 28520362.

Please affix

your Passport Size

Photograph here.

Candidate ID: 64334662F

OR

OF

FIC

E

US

E O

NL

Y

Status : ..............................

TC / Unit : ..........................

APPLICATION FOR FRESHERS

PE

RS

ON

AL

DE

TA

ILS

GAUR

(First Name) (Middle Name) (Surname)

ADDRESS FOR COMMUNICATION : DATE OF BIRTH ( dd / mm / yyyy ):

GENDER (Please Tick 'ü' )

10/08/1993

Male Female

CITIZENSHIP :

ED

UC

AT

ION

A B

__ ___ _______

NAME OF THE COLLEGE :

E-mail :

DO YOU HAVE A PASSPORT? Yes No

No. NA........ ......................................................................................................................................

XII STD / EQUIV.

State

Name of the School / College

Branch / Stream / Area of Specialization

Month and Year of Passing

Simple Average Percentage / CGPA / Grade *

* ALL PERCENTAGES / CGPA SHOULD BE SIMPLE AVERAGE FOR ALL YOUR SUBJECTS / SEMESTERS / YEARS, INCLUDING ELECTIVES, OPTIONAL SUBJECTS, ADDITIONAL SUBJECTS, PRACTICAL SUBJECTS AND LANGUAGES.

ANY ACTIVE BACKLOGS ? YES Number of active backlogs: NA NO

GAPS IN EDUCATION (IF ANY): Years. Reason:

Uttar Pradesh

St Peter's College,Agra

St Peter's College

Uttar Pradesh

Maharaja Surajmal Institute of Technology

Delhi

General Science Electrical & Electronics Engg

94.2 94.5 81.4

05 / 2009 05 / 2011 07 / 2015

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Guru Gobind Singh Indraprastha Univ.

Indian School Certificate Examination

Indian Certificate Of Secondary Education

Name of the Board / University

Name of the Qualificatiion Awarded

Others Others Bachelor Of Technology

DIPLOMA / OTHERS

POST GRADUATION

GRADUATIONX STDEDUCATION LEVEL

Role : .................................

VER 1C 2 of 2 HRD/REC/F/013

Have you at any time been convicted by a court of India for any criminal offence and sentenced to imprisonment, or are any criminal proceedings pending against you before a court in India, or has an order prohibiting your departure from India, been issued by a court ?

If yes, please give details of the same

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ARE YOU CURRENTLY EMPLOYED WITH ANY OF THE INFOSYS GROUP COMPANIES ? IF YES, INFOSYS BPO OTHERS Please Specify NA

NA

I certify that the academic marks / CGPA are simple average for all subjects / semesters / years including electives,optional subjects,additional subjects, practicals and languages.

I authorize investigation of all statements made in this application and my supporting documents. I authorize Infosys to secure information about my experience from former employers, educational institutions, government agencies or any references I have provided, and for those parties to provide information concerning my qualifications for employment and I hereby release all parties from any liability arising from such investigation.

I understand that if I am employed, any false statement, misrepresentation, or omission of facts on this application or on any supporting documents, regardless of when discovered to be false, may result in my immediate dismissal. The company will have the right to withdraw my letter of appointment or to terminate my training / subsequent appointment at any time without notice or compensation.

My signature below certifies that I have read, understood, and agree to the foregoing and to the best of my knowledge and belief, the information on the application form is true and correct.

Date : ...................................... Place : ................................................. Signature: ...............................................................

WO

RK

EX

PE

RIE

NC

E

PLEASE WRITE 'NA' IF NOT APPLICABLE. Specify clearly in case of part time / contract work experience. Notice period required.......................................... (in weeks)

ORGANIZATION

PERIOD( MM / YYYY )DESIGNATION

GROSS SALARY

REASON FOR SEPARATION

LEGAL OBLIGATIONS.IF ANY ( Y / N )

MIS

CE

LL

AN

EO

US

HAVE YOU UNDERGONE ANY SELECTION PROCESS WITH INFOSYS OR INFOSYS GROUP COMPANIES (LIKE INFOSYS BPO, ETC.) PREVIOUSLY ? IF YES, HAVE YOU INFOSYS OTHER INFOSYS GROUP COMPANIES - TAKEN ANY TEST ? - BEEN SELECTED FOR INTERVIEW ? - BEEN MADE AN OFFER ? - JOINED ?

YES NO

NO YES

NO

NO

YES

YES

RELEVANT DATES RELEVANT DATES

NO

NO

NO

YES

YES

YES

NA

NA

NA

NA

NA

ARE YOU EMPLOYED AS : 1. A DIRECTOR IN ANY OTHER COMPANY ? 2. A PARTNER IN ANY FIRM ?

YES

YES NO

NO

YES NO

FO

R O

FF

ICE

U

SE

ON

LY

Date of Test / Interview :.............................................. Date of Interview (if differ from Date of Test) :.............................................. Result : (Please 'ü' ) Name : .......................................................................................... Emp. No. : ............................ Signature : ....................................................

Selected Hold Rejected

DE

CL

AR

AT

ION

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NA

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NA

NA

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NA

TO DURATIONFROM

YES NO

NO YES NO YES

IF YES, PLEASE PROVIDE DETAILS