Doc Ver 4.3 Accenture Services Private Ltd.

Effective from Nov 1, 2010

Employment Application Form

For internal use only: To be filled by Accenture

Employee ID Number: Please attach recent
Date of Joining :
passport size
Workforce :
photograph
 Please provide complete and correct information.
 All fields are mandatory.
 Please do not use short forms / abbreviations.
 Hardcopy of this form along with supporting documents has to be submitted (duly
signed & with a recent colour photograph) to your location contact point.
 Personal Details
Please expand initials in your name -- As the same would be used in our Employment records

Doc Ver 4.3 Accenture ServicesFirst

Title (Mr./Ms.) Private
Name Ltd. Effective Middle
from NovName
1, 2010 Last Name

Education Details (Please mention all education details starting from highest full time degree obtained)

Primary Skill
Qualification with /
Institution Name & City University Name & City Period Student ID / Program % age marks /
Specialization
Competency(School/College) / Board Affiliated To (From – To) Reg No. (Part Time / Full CGPA
(Starting from most (dd/mm/yyyy) Time)
recent)
PGDM( FINANCE
Gender:JAIPURIA
o Male INSTITUTE
o FemaleOFNationality:AICTE
………………….. JUNE 2007 TO…………………….
Citizenship: P07015 FULL TIME 6.74 CGPA
& MARKETING) MANAGEMENT APRIL 2009
Date of Birth : ………………………… Place of Birth:…………………………….

Maiden Name: (applicable for married ladies): ……………………………………….

BSC(COMPUTER ATMA RAM SANATAN UNIVERSITY OF JUNE 2004 TO 7217 FULL TIME 56%
SCIENCE) Father’s Name:
DHARMA COLLEGE
…………………………………………….. DELHI APRIL 2007

Mother’s Name: …………………………………...............

HSC/ 12th HOLY MISSION HIGH CBSE JUNE 1999 TO 5617245 FULL TIME 68%
Mother’s Maiden Name: …………………………………..
SCHOOL MARCH 2001
Contact Number/s: …………………………………………

SSC/ 10th Personal Email ID: ………………………………………………………….

JAWAHAR NAVODAYA CBSE JUNE 1994 TO 5100647 FULL TIME 70%
VIDYALAYA MARCH 1999
Alternate Email ID: …………………………………………………………..

Current Address : Permanent Address :

Others

State reasons for gap in education (if any) :

Phone Number : Phone Number :

Current Address Permanent Address

From To From To • Ensure that
Period Of Stay (month/year) (month/year) (month/year) (month/year) you are
descriptive
JUNE 2007 wherever
--------- JANUARY 1983 --------
necessary
– e.g. If
your
Preferred Work Location: Bangalore Hyderabad Mumbai Chennai Kolkatta Pune NCR (Delhi/Gurgaon/Noida)
Any

If you do not have a Passport, it is recommended that you apply for the same before joining.
Doc Ver 4.3 Accenture Services Private Ltd. Effective from Nov 1, 2010

previous company is closed down, please do mention it. Telephone Number with specific location code, Employee Code/ ID/ Number is mandatory. If your
previous employer did not provide the Employee ID, please mention and state reasons for the same
• Employment details should be of the company you are on payrolls of, not of a company you are deputed to on an assignment with. In case you are
showing employments experience in a skill enabling or professional Training institute the same should only be shown if you were on the payrolls of such
an institute.
 Doc Ver 4.3 Accenture Services Private Ltd. Effective from Nov 1, 2010

Employment Details (Please mention all the employments starting from the latest employment)
Note: Verification of your current employment would be obtained on or after joining Accenture.
Sl Company Address Employment Reported to Employ Emp Code / Last Reasons Mode of
No Name (Main office & Type (Name & ment Personnel drawn for separation from
branch where & Position & Period No. / Social monthly leaving the organization
worked) with Designation/ direct contact From - Security gross (Pls select the
Company Position number) To No. salary below option)
Telephone – held (dd/mm/ (Mandatory (INR)
Board Line yyyy) if worked in
USA)
INFOSYS CHATRALA HITESH 27/04/20 933804 11781 FOR Resignation
BPO LTD. CIRCLE, Permanent KHATRI, 09 BETTER Termination
Employer 1

SITAPURA Contract TEAM CAREER Absconded

INDUSTRIAL Designation LEADER, OPERTU Closed
PROCESS MOB- NIT Y Operations
AREA, JAIPUR 967282311
EXECUTIVE Others(Pls
……………… Specify)
…..
VINEET BAGHI, POST- VINEET 08/04/20 --------- 5000 HIGHER Resignation
GARMENT SUHIRD Permanent KUMAR 01 TO STUDY Termination
Employer 2

WORKS NAGAR, DIST- Contract SINHA, 12/05/20 Absconded

BEGUSARAI, Designation DIRECTOR, 04 Closed
BIHAR SALES MOB- Operations
EXECUTIVE 83545128 Others(Pls
……………… Specify)
…..
Resignation
Permanent Termination
Employer 3

Contract Absconded
Closed
Designation
Operations
Others(Pls
………………
Specify)
…..
Resignation
Permanent Termination
Employer 4

Contract Absconded
Closed
Designation
Operations
Others(Pls
………………
Specify)
…..

Letter of Authorization
To whom it may concern

If employed by Accenture, I agree to provide copies of mark sheets and relevant certificates. I understand
that employment with Accenture is governed by Accenture Employment Policies as applicable, including
satisfactory information from a background check.

I hereby certify all of the statements made on the Accenture Services Private Ltd Employee Application
Form are true and complete and I understand that omission or misrepresentation of any fact may result in
refusal of employment or immediate dismissal.
 Doc Ver 4.3 Accenture Services Private Ltd. Effective from Nov 1, 2010

I hereby authorize Accenture Services Private Ltd and its representative to verify information provided in my
resume and application of employment, and to conduct enquiries as may be necessary, at the company's
discretion. I authorize Accenture Services Private Ltd. and its representative to initiate the necessary
enquiries/checks with immediate effect; barring my current employment. Verification of my current
employment can be initiated on or after the date of joining. I authorize all persons who may have
information relevant to this enquiry to disclose it to Accenture Services Private Ltd. or its representative. I
release all persons from liability on account of such disclosure.

Signature :

Name in Capitals :

Date :