TCS EMPLOYMENT APPLICATION FORM

BASIC DETAILS
Reference # CT20151754529

PERSONAL DETAILS
College/Institute Govt College of Engineering, Jabalpur
Name Mr. Sourabh Kumar
Mother's Maiden Name Ranjan Devi
Father's Name Mr.Sanjay Kumar Jha
Date Of Birth 26/10/1991
Nationality India
Gender Male
Area Of Interest IT Application Development And Maintainance,IT
Infrastructure Services,Engineering and Industrial
Services,Research

CONTACT DETAILS
PERMANENT ADDRESS
House No./Apartment Name/Block No Vill+Po-Khara Budhama
Road/Street/Lane
Area/Landmark Madhepura
City Madhepura
State Bihar
PIN Code 852210
Country India

PRESENT ADDRESS
House No./Apartment Name/Block No Vill+Po-Khara Budhama
Road/Street/Lane
Area/Landmark Madhepura
City Madhepura
State Bihar
PIN Code 852210
Country India
ACADEMIC DETAILS:
Degree Course Duration Duration Course University/Institute Board Of Specialization CGPA/Marks Total Percentage
Name From To Type Education Obtained Marks/CGPA
Post Graduate Master Of 15/07/2014 15/07/2016 Full Time Govt College Of High Voltage 6.91 10.0 69.1
Technolog Engineering, Jabalpur Engineering
y
Graduate Bachelor 15/07/2010 15/07/2014 Full Time Rajiv Gandhi Electrical & 7.12 10.0 71.2
Of Science Proudyogiki Electronics
(Engineeri Vishwavidyala, Bhopal Engineering
ng)
XII 15/06/2009 15/06/2010 Full Time R.M.College Saharsa State Board Pcm 304.0 500.0 60.8
X 10/07/2007 10/07/2008 Full Time S.S.H.S Khara State Board 325.0 500.0 65.0
Are there any break in studies ? No
Rewards Or Scholarships : No
Academic Projects Undertaken: No
Have you done any other course ? No
Do you have any pending backlogs No
currently ?
Declaration
1. You have taken all subject marks into consideration for calculating the obtained/Total Marks/CGPA in each
of the above mentioned academic qualifications :
Yes
2. The "Marks/CGPA Obtained" entered by you for each of the above mentioned academic qualifications has
been secured in the first attempt :
Yes
3. You have considered only the Marks/CGPA obtained during the normal duration of the course for calculating
Obtained/Total Marks/CGPA :
Yes
4. You have completed each of the above mentioned academic courses in the stipulated time as specified by
your University/Institute and as per TCSL selection guidelines and do not have any extended education:
Yes
5. You have declared break in studies/work experience and pending backlogs,if any, during your academics:
Yes
6. You have not attended the TCSL Selection Process in the last 6 months:
Yes
7. You have read the TCSL eligibility criteria and understand that your candidature/application/offer/ on
boarding is subject to fulfillment of the specified criteria :
Yes
I Mr. Sourabh Kumar solemnly declare that the information in this form is truly stated and correct and I am competent to
furnish as well as verify it with adequate details whenever requested for by TCSL.
CONTACT DETAILS
E-mail ID pujakumari2145@yahoo.com
Telephone(R) 9200218728
Alternate E-Mail ID pujakumari2154@yahoo.com
Telephone(M)

LANGUAGE DETAILS:

Language Mother Tongue Read Speak Write

English No Yes Yes Yes

Hindi Yes Yes Yes Yes

TCS RELATED DETAILS:

Have you appeared for TCS Test / Interviews earlier? No

In connection with my application to render services to Tata Consultancy Services Ltd (the "Company"), I hereby agree as
follows:I certify that the information furnished in this form as well as in all other forms filled-in by me in conjunction with my
traineeship is factually correct and subject to verification by TCS including Reference Check and Background Verification. I
accept that an appointment given to me on this basis can be revoked and/ or terminated without any notice at any time in
future if any information has been found to be false, misleading, deliberately omitted/suppressed. As a condition of
Company's consideration of my application for traineeship with the Company, I hereby give my consent to the Company to
investigate or cause to be investigated through any third parties my personal, educational and pre or post joining history. I
understand that the background investigation will include, but not be limited to, verification of all information given by me to
the Company. I confirm that the Company is entitled to share such investigation report with its clients to the extent necessary
in connection with the Services, which I may be required to provide to such clients. I confirm and undertake that the
Company shall incur no liability or obligation of any nature whatsoever resulting from such investigation or sharing of the
investigation results as above. I certify that I am at present in sound mental and physical condition to undertake employment
with TCS. I also declare that there is no criminal case filed against me or pending against me in any Court of law in India or
abroad and no restrictions are placed on my travelling anywhere in India or abroad for the purpose of business of the
Company.

Your Electronic Signature is:

Name:Mr. Sourabh Kumar

Date:17/09/2015

Place:Madhepura

TCS is an equal opportunity employer that aims to integrate global diversity and inclusion at each level within our
organization. Hiring decisions are solely made on the capability of an individual to perform a role. Any personal details like
gender, age and nationality that may be provided by you during the course of application or selection process will be used for
administrative records and all qualified applicants will receive consideration for employment without regard to this
information.