RELIANCE GROUP OF COMPANIES

Recruitment Cell Petroleum Business (Exploration & Production)

Reliance Corporate Park (NOCIL Complex), 5, TTC,
Industrial Area, Gate-A, Building No-8, 2nd Floor, D- Wing,
Ghansoli, Thane-Belapur Road, New Mumbai- 400701.

CONFIDENTIAL
AFFIX
PHOTOGRAPH HERE

PERSONAL HISTORY FORM

Date of Joining:
AA.
PERSONAL & FAMILY BACKGROUND
01.

NAME

02.

PLACE & DATE OF BIRTH (AGE)

03.

YOUR WEIGHT:_______ KGS.

YOUR HEIGHT: ______Cms.

04.

YOUR EYESIGHT

RELIGION:

05.

PRESENT MAILING ADDRESS

TEL. NO.:_____________

06.

PERMANENT ADDRESS

TEL.NO.:____________

07.

CONTACT ADDRESS IN CASE OF

EMERGENCY

TEL.NO.:____________

08.

YOUR PRESENT RESIDENCE

a)

Staying in your own house/flat

b)
c)
d)
e)

Staying in company quarters

Staying with parents/relatives
Staying on rental accommodation
Rent charges per month

09.

10.

PERSONAL STATUS
BACHELOR/ENGAGED/MARRIED/WIDOWER
If married number of children with their names & dates of birth
BOYS
DATE OF
PLACE OF
GIRLS
DATE OF
PLACE
BIRTH
BIRTH
BIRTH
OF
BIRTH

FAMILY BACKGROUND
NAME

A)
B)
C)
D)
E)

11.

12.

PLACE OF
BIRTH

DATE OF
BIRTH

OCCUPATIO
N

QUALIFICATION

FATHER
MOTHER
SPOUSE
BROTHERS

1.
2.
SISTERS
1.
2.
NAME, OCCUPATION AND ADDRESS OF OTHER RELATIVES WHOM WE MAY
APPROACH, IF NECESSARY:

GIVE TWO (2) REFERENCES (NOT RELATIONS) WHOM WE CAN REFER FOR
VERIFICATION.

1.

TEL.NO.

2.

TEL.NO.

13.

HOW MUCH ARE YOU EARNING AT PRESENT? Rs.____________p.m.

14.

(Please state Basic allowances and other benefits separately. You may need to support
this with a salary certificate).
HOW MUCH WOULD YOU LIKE TO EARN IN A NEW JOB?
At present

Rs.___________________ p.m.

After one year

Rs.___________________ p.m.

After 5 years

Rs.___________________ p.m

15.

HOW DO YOU KEEP YOURSELF IN GOOD PHYSICAL HEALTH?

16.

HOW DO YOU CONSIDER IS THE PRESENT STATE OF HEALTH OF

YOURSELF

YOUR SPOUSE

FATHER

MOTHER

YOUR CHILDREN :
17.

ANY OTHER INFORMATION ABOUT YOUR FAMILY OR YOURSELF THAT

YOU WOULD LIKE TO ADD?

18.

YOUR RESPONSIBILITIES - HOW WILL THEY AFFECT YOUR JOB?

(Worries regarding financial support, childrens marriages, etc.)

19.

HAVE YOU BEEN CRIMINALLY PROSECUTED? IF SO, GIVE DETAILS

SEPARATELY?

20.

CONVEYANCE
a) Do you own a vehicle ? If yes, please describe
b) If No, how do you commute at present?

BB.

EDUCATIONAL QUALIFICATIONS : (Starting from S.S.C)

Sr. Exams & Year
No. Passed
a.

School /
College

Board /
University

b.
c.
d.
e.
f.
g.

Class / Marks
Obtained

Main Subjects

TRAINING & PRACTICAL EXPERIENCE (Other than regular jobs):

Sr.
No.

CC.

Nature of Training

Organization /
Institution

Period
From

To

DETAILS OF WORK EXPERIENCE :

Please record your experience, details in chronological order starting from
present employment.
Dates

Entry
-----Exit
Entry
-----Exit
Entry
-----Exit
Entry
-----Exit

Name & Address

of the Employer

Designation

Duties

Salary
Net (Rs.)

_________

________

_______

_________

________

_______

_________

________

_______

_________

________

_______

Reasons for
Leaving

ORGANISATION CHART
Kindly draw the reporting relationships above and under you :

1.

IF YOU ARE THE HEAD OF A DEPARTMENT OR THE COMPANY YOU ARE

WITH, PLEASE STATE IN BRIEF YOUR RESPONSIBILITIES, NUMBER OF
PEOPLE SUPERVISED AND WHOM DO YOU RESORT TO. ALSO STATE IN
BRIEF THE NATURE OF YOUR WORK?

2.

PLEASE DESCRIBE IN DETAIL YOUR FUNCTIONS / RESPONSIBILITIES DURING

THE LAST FIVE(5) YEARS OF YOUR SERVICE (USE SEPARATE SHEETS IF
REQUIRED).

3.

DO YOU HAVE ANY CHOICE OF LOCATION OF WORK ?

(Please state in order of preference)

DD.

GENERAL DEVELOPMENTAL WORK:

1.

WHAT BOOKS AND JOURNALS DO YOU NORMALLY READ AND LIKE?

2.

IN WHICH FIELD ARE YOU BEST INFORMED?

3.

HAVE YOU PUBLISHED OR WRITTEN ANYTHING? IF YES, GIVE DETAILS.

(Please send a copy of your publication, if readily available)

4.

HAVE YOU DONE ANY RESEARCH, DEVELOPED NEW IDEAS OR INVENTED

ANY TOOL/ MACHINERY/ GADGET? (Describe in brief).

5.

MEMBERSHIPS: Professional Societies / Social and Cultural Associations/ Political,

Semi-/Political Parties, Educational or any other Societies and Group.

EE.

PERSONALITY (INTERESTS AND AMBITIONS)

(Please state briefly in the space provided below)

1.

What seems to be your greatest problem/ anxiety/ worry at present?

2.

What is your objective in life?

3.

Are you doing anything at all to achieve this objective? If yes, describe.

4.

What are your greatest personal assets(qualities, skills, abilities?) which make you
successful in the jobs you take up?

5.

What do you enjoy most in your work?

6.

What do you consider your main weakness?

7.

What are your strong likes, dislikes and prejudices?

8.

Would you like to go out of India? Yes / No. Are you doing anything at all to achieve this
objective? If yes, describe.

9.

Would you be prepared to enter into a Service Agreement for a fixed period with our firm?
Write Yes or No against each.
a)
General Service Contract

5 years
b)
Training/ Study/Tour abroad cum Service Contract

3 years
c)
Tour abroad on assignment

2 years
(duration 2 to 8 weeks)
d)
Training in India (Management training - duration 3

1 year
to 6 months) cum Service Contract
LANGUAGES:

10.

READ

11.

SPEAK

WRITE

Any other information you would like to add.

HOW DO YOU KNOW?

FF.

REMUNERATION STRUCTURE
(You may need to support this with a salary certificate)

1.
1.1
1.2
1.3
1.4

Level & Grade

Basic Salary
Dearness Allowance
Fixed D. A.
TOTAL CONSOLIDATED SALARY

2.1
2.2
2.3

House Rent Allowance

Any special facility regarding housing
TOTAL (2.1 + 2.2)

3.1
3.2
3.3

Car / Conveyance Allowance

Transport facility (specify)
TOTAL (2.3 + 3.1 + 3.2)

4.1
4.2
4.3
4.4
4.5
4.6
4.7
4.8
4.9

Bonus / Ex-gratia
LTA
Scholarship / Education Allowance
Canteen / Lunch Expenses
Entertainment Expenses
Furnishing (Hard / Soft)
Servants
Residence / Telephone/ Maintenance
TOTAL

5.1
5.2
5.3
5.4
5.5
5.6

Provident Fund (Rate)

Gratuity (Rate)
Superannuation Fund (Rate)
Hospitalisation Insurance
Medical Reimbursements
(Maximum Limits)
Group Life / Accident Insurance

6.1
6.2
6.3

Gross Salary
Income Tax Paid
NET SALARY

7.1
7.2
7.3
8.1

Leave - Casual / Sick / Privilege

Leave - Any other (specify)
Leave - Accumulation / Encashment
Any Loan Facilities (Specify)

Present

Expected

Proposed

DECLARATION
PRIOR ASSOCIATION
Have you ever applied or been interviewed for a job in this Company or in any of the
RELIANCE Group or Associate Companies. YES / NO
If Yes, please give details :
Position :

Outcome :

Have you ever worked in this Company or in any of the RELIANCE GROUP or
Associate Companies before? YES/NO
If Yes, please give details :

ACQUAINTANCES / RELATIVES
Indicate acquaintances and relatives (in the widest sense) associated with the Reliance
group and Associate Companies.
Name
Relationship
Particulars
Company
(i.e Position etc.)

REFERENCES
Name & Address of one person other than relatives to whom we may write to :
1.
Date:
Name:
Signature:

10