Ibm Employment Application Form V5.0 Wef 06aug2012 2i1r2y

Employment Application Form

Please affix your port size photo here

Please read the below instructions carefully before you start filling in the requested information:

1) Please read all instructions for each section and fill in as instructed. All fields are to be filled legibly, completely and accurately in CAPITAL letters to reduce delay in processing your candidature with IBM. 2) Please bring the following documents with you to the personal interview at IBM: i) Completed IBM Employment Application Form ii) Proof of Salary Documents Offer letter with compensation break up OR Latest increment letter from present organization with compensation break-up iii) Updated Resume iv) Valid Photo ID (port, PAN Card, Voter’s ID card, Driver’s License) Past IBM Interview Details (Fill in CAPITAL Letters) Have you attended any IBM Interview in the last 3 Months

Yes

No

If Yes, please provide the below details: D

D

M

M

M

Y

Y

Y

Y

Date of Interview Position Applied

Work in Progress

Received Offer

Rejected/Declined

IBM India Pvt Ltd

IBM Daksh

IBM NetSol

Location Of Interview IBM subsidiary Name

Page 1 of 6, Employment Application form, version 5.0, wef - 06th Aug 2012

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SOURCE INFORMATION (Fill in CAPITAL Letters) How did you know about this vacancy in IBM? (Select any one of the below)

Agency

Direct - IBM Website

Accepted Not ed Candidate

IBM Employee Referral

Agency name

Name of the Employee

Employee Number (If Applicable)

It is important that you mention the employee ID or Email ID accurately, please confirm with the referrer if you are not sure of the information

Jobsites Job Site Name

E- Mail ID

By submitting the IBM Employee Referral name you confirm that the referrer is known to you personally or professionally. This relationship may be a result on of participation in various social networks which are either formal (examples of formal networks are Linkedin, Facebook, Twitter, industry and competency associations) or informal (examples of informal networks are former employment with the same company, friends circle, alumni from same educational institution or study circles) . You also confirm that the referrer has made you aware that by referring your candidature to IBM for an opportunity of employment, he/she may be eligible to receive a referral bonus.

IBM Application ID *

C

* If you have already ed on our IBM Job Portal please provide the IBM Candidate Applicant ID also called GOM Candidate Applicant ID. If you are referred by an Agency, please ask your agency for the Applicant ID

PERSONAL INFORMATION (Fill in CAPITAL Letters) * Enter your name as per your port, Driver's Licence OR PAN Card (For Indian Nationals) Title Mr.

Ms.

First Name Middle Name

Last Name

D

D

M

M

M

Y

Y

Y

Y

Date of Birth **e.g. 01 - JAN - 1900

Mobile Number **Country code - Mobile Number Telephone

**Country code - City Code - Telephone Number

Personal Email ID

Pan Card

(If you are an Indian National)

Driver's Licence #

port Number

D

D

M

M

M

Y

Y

Y

Y

Expiry

Place of Issue Refer to the port for this information Page 2 of 6, Employment Application form, version 5.0, wef - 06th Aug 2012

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PERSONAL INFORMATION…… CONTINUED (Fill in CAPITAL Letters)

Nationality

City of Birth

Country of Birth

Current Address

PIN Code

City State Country Permanent Address (If different from the above)

PIN Code

City State Country

PROFESSIONAL REFERENCES (Fill in CAPITAL Letters) Please provide details of three professional references with whom you have had a business/Working relationship of which one reference has to be mandatorily your previous Manager's details Please exclude Friends, Colleagues, Juniors, Relatives at work and Clients Name

Number

Nature of professional Relationship

Current occupation

Comments*

*Please use the comments column to indicate if you do not wish IBM to one or any of the above for pre-reference checks.

Page 3 of 6, Employment Application form, version 5.0, wef - 06th Aug 2012

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EDUCATION DETAILS (Fill in CAPITAL Letters) COMPLETED degree programs only.

Please complete all fields, even if you have already provided a resume. Provide details on Highest Qualification (Completed)** e.g.: M.Sc, B.Com ** Highest education declared has to be minimum 02 year degree or diploma awarded by a University or a Board or its s

PLEASE MENTION COMPLETE DETAILS OF SCHOOL / COLLEGE / INSTITUTION AND UNIVERSITY NAME ALONG WITH COMPLETE ADDRESS WITH CITY & POSTAL CODE IN CAPITAL LETTERS

Qualification

Complete Name & Address of School / College / Institution and Name of the University *University name is mandatory where applicable(DO NOT ABBREVIATE)

Course Tenure

M

M

M

Y

Y

Y

Y

Y

Y

Class/ Registration / Division/ Roll / Final Percentage/ Year Seat Grade Number Points

Name of the Degree Awarded (e.g.. B.com / BA/ Mtech)

Start Date SSLC ( 10th) End Date Year of ing

* E.g. JAN09 M

M

M

Start Date HSLC (12th) End Date Year of ing

* E.g. JAN09 M Graduation

M

M

Start Date End Date University Name

Year of ing

* E.g. JAN09 M

M

M

Y

Y

Post Start Date Graduation End Date University Name

Year of ing

* E.g. JAN09 M

M

M

Y

Y

Others - PhD, Start Date Additional Degrees End Date University Name

Year of ing

* E.g. JAN09 Professional Qualification Start Date (Other than already End Date mentioned above) like CA, Year of ing CFA etc

M

M

M

Y

Y

* E.g. JAN09 State reasons for GAP in education, if any : Professional Training (includes in progress degrees) - please mention the details ______________________________________________________________________________________________________________________________________________ Page 4 of 6, Employment Application form, version 5.0, wef - 06th Aug 2012

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EMPLOYMENT HISTORY (Fill in CAPITAL Letters)

Provide your job history for a minimum of the last five (5) years (if applicable). Additionally, include your last three 3 employers (if applicable) even if your total service exceeds 5 years in the last 1 or 2 companies. Please include information on Self employment within the same period. Do you have prior employment experience?

Yes

No

PLEASE MENTION COMPLETE DETAILS OF ORGANISATION NAME, COMPLETE ADDRESS WITH STREET NAME, AREA, CITY & POSTAL CODE IN CAPITAL LETTERS Employment Type (Permanent Organisation Name and address /Contractual) and Tenure Band / Grade details

Serial No Organisation Name

D

D

D

D

M

M

M

Y

Y

Y

Y

Y

Y

Employee Number

Full Time / Part Time

Start Date

Address

1

End Date * E.g. 01-JAN-1900

Pin Code Organisation Name

M

M

M

Start Date

Address

2

End Date * E.g. 01-JAN-1900

Pin Code Organisation Name

D

D

M

M

M

Start Date

Address

3

End Date * E.g. 01-JAN-1900

Pin Code

Below is continuation of the above table. E.g. Continue to fill in details of "Serial No 1" (Above) in "Serial No 1-Continue" row below. Serial No

Designation

Reasons for Leaving

Reporting Manager's Name and number)*

If Employment Type is Contractual, Please Provide Agency Name, COMPLETE Address and Number

Organisation Name Complete Address

1Continue

Pin Code

Number

Organisation Name Complete Address

2Continue

Pin Code

Number

Organisation Name Complete Address

3Continue

Pin Code

Number

*Current Reporting Manager will be ed ONLY AFTER the candidate s IBM Total years of experience - (please do not include any training or internship experience) State GAP in Employment if any:

Page 5 of 6, Employment Application form, version 5.0, wef - 06th Aug 2012

Years

Months

5

Present Employment Compensation Details** (Fill in CAPITAL Letters) ** The information stated here must be ed with documentary evidence (Offer letter from present organization including Compensation break up details or most recent increment letter) Please mention below your annual compensation details (A). Fixed Pay including statutory benefits (Rs.)

(B).Variable Pay (Rs.)

Annual Current CTC = Total of A + B + C (Rs.)

Comments

(C). Other allowances (Rs.)

OTHER DETAILS (Fill in CAPITAL Letters) Have you worked for IBM earlier?

Yes

No

If "YES", please provide following details: Tenure (DD-MMM-YYYY) Business Unit

Location

Date of ing

Last working day

Yes

Are you willing to relocate as part of your employment with IBM? If "YES", please indicate your preference

Status (Regular/FTH/Contractor)

Manager's Name

Employee No. / Contractor Code

No

_______________________________________________________________________

If you are related to IBM India Private Limited employees and/or Directors (sibling / spouse/ children/in law relationships), please provide names and relationship. Name

Designation

Business Unit

Relationship

Consistent with IBM's policy on workforce diversity and in order to accommodate employee's special needs in the work environment, please indicate if you are physically challenged **

Yes

No

If yes, please provide description of disability and accommodation required: ** IBM Corporation is an Equal Employment Opportunity Employer Do you have any non-compete obligations or conflict situations or other restrictive clauses with any party including any of your previous employers that prevent you from working for IBM India Private Limited?

Yes

No

Have you worked for the Government, whether as a civilian employee or member of the military? Yes No All Candidates must indicate if they have worked for the Government, whether as a civilian employee or member of the military. If so, you must also indicate whether you had any responsibilities or were involved in activities relating to IBM or an d Company. You must also state whether you are aware of any legal restrictions on what work you may do for IBM or an d Company, and if so, what those restrictions are. Name of Government Organization and Department Tenure Job Responsibilities Restictions ( if any)

Declaration • If applicable, I hereby confirm that in my duties as a government employee, I have (or have had) no matters involving IBM (in any capacity whatsoever), or if I do, that I have officially withdrawn from participating in those matters while I am discussing potential employment with IBM. All details of any such matters that I have been involved with, where IBM or any of its s have been involved, are listed above. • I confirm that the information provided by me in this application form is complete and accurate. • I understand that if any information provided by me with respect to my application for employment is found to be untrue, inaccurate or misleading, IBM INDIA Private Limited may withdraw any offer of employment made to me or terminate my employment (If I have already ed IBM India) without notice. • I understand that all the details provided in this application are subject to verification. • I hereby authorize IBM India Private Limited and its representatives (including reference check agencies/third party vendors) to information provided in my application for employment and to conduct enquiries as deemed necessary by the company. • I authorize all persons who have information regarding my education, employment, and all other details provided in this form, to disclose it to IBM or its representative.

Signature:

Place: Page 6 of 6, Employment Application form, version 5.0, wef - 06th Aug 2012

Date:

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