Job Application Form

Photo (passport size)

Post applied for: Applied for the job through:

1. Name (in full) Gender:

2. Father’s Name: 5. Passport No

3. Place of Birth: 6. Nationality:

4. Date of Birth: Age: 7. Driving License No:

8. Present address 9.Permanent address

Telephone No. : Telephone No. :

10. Do you have any physical disabilities? Yes No

If yes, kindly specify in detail

11. Marital Status: Single Married Divorced

12. Family Details:

Relationship Name Age Occupation

1 Father
2 Mother
3 Spouse
4 Children

5 Others

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13. Do you have any relations employed in Michelin?

If 'Yes', give details yes No

Name Relationship Name of Company Person/Dept

14. Have you previously submitted an application for employment with Michelin?
If 'Yes', when? What was the outcome?

15. Educational Qualification (from College):

College/Institute Exam Year of Main Class / % of

& Location Passed Passing Subjects Marks obtained

16. Brief particulars of project work in College/Institute:

17. Awards and Recognition's obtained:

18. List of articles (if any) published:

19. Details of Special Training/Skills acquired & additional courses undergone:

20. Extra Curricular Activities / Hobbies & Sports:

21. Language Proficiency: (Underline Mother tongue)

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 Languages Speak Read Write

22. Areas of specialization (job Specific) :

23. Are you directly or indirectly involved in any Business/Agency? Yes No

If yes please give detail

Name Of The Designation Period From-To CTC Reason For

Company & Change
Place Of Work

Space for Any Additional information-If Any

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I confirm that all information given by me in this application is true and correct to the best of my
knowledge, I also agree to co-operate and furnish all required details for a medical test and
background verification, and if any of the particulars found to be false at any given point the
company can terminate my services forthwith..

Place:

Date : Signature
(Name :