German Bangla Chemicals

Quality product at affordable cost

Cell: +8801799445740. Email: sohorowordy@erp.com.bd
www.germanbangla.com

EMPLOYMENT RECORD

Employment No: Reporting Time: 09:36 AM 15-03-2025

Please answer each question clearly and completely. The information will be treated as private and confidential.

1. Name:
2. Position: Joining Date:
3. National ID:
4. Father's Name:
Occupation:
5. Mother's Name:
Occupation:
6. Mailing Address: ,
,
,
,
,
7. Permanent Address: ,
,
,
Home District:
Cell No: Tel/Cell No:

8. Date Of Birth: 9. Place Of Birth:
10. Nationality: 11. Religion: 12. Blood Group:
13. Sex: 14. Marital Status:
15. Spouse's Information (If Applicable):
Name: Blood Group:
Occupation: Nationality:

16. Name of Dependents:(Including Parents, Spouse & Children who are dependent on you for Support):

SL Name Date of Birth Relationship
SL Name of Child Education Level Blood Group

17. Have you ever been arrested, indicted or summoned into court as defendant in a criminal proceeding, or convicted, fine or imprisoned for the violation of any law (Excluding Minor Traffic violations):

18. Language Proficiency(Excellent/Good/Satisfactory/Poor/None):

SL Language Spoken Written

19. Educational & Professional Qualifications. Give full details i.e School/College/University/Institution:

SL Institution (Name & Place) From To Degree Div/Class/Grade Main Course of Study

20. If you Have any relative(s) working in Radiant, provide the following:

SL Name Relation Unit Department Designation Location

21. Professional Membership(if any):

SL Name

22. Other Qualifications (Course attended, training received or certificates obtained - not less than 7 days):

SL From To Course Attended Institute Country

23. Employment Record (Start with your present job first):

SL From To Name & Address of Employer Last Salary Drawn Job Title and Duties Reason for Leaving

24. Are you suffering/had suffered from any chronic/serious illness? (YES/NO) If YES, Give Details:

25. Hobbies & Interests:

SL Name

26. Special Skills:

SL Name

27. Have you ever been dismissed or terminated from any employment? (YES/NO) If YES, Give Details:

28. Reference: List two persons not related to you, who are familliar with your character, qualifications and competence, whom the company may contact at any time:

SL Name Occupation Address Tel No

29. Contact Persons:

SL Name Relationship Address Tel No

DECLARATION

I hereby declare that,


1. The perticulars furnished in this applications are accurate and complete to my knowledge and belief and have not knowingly withheld any information, which, if disclosed, would affect my application unfavourably.


2. I shall be deemed to have been guilty of gross default, misconduct in the event of my appointment with Radiant if at any future date it is found that my declaration as above is false or materially incorrect in any respect and in that case my service with the company will be liable to be terminated without notice or payment of benefit whatsoever.


3. In the event of my being selected for employment with Radiant, I agree to abide by the rules and regulations of the company which may be in force from time to time.


Signature :
Date :