Documente Academic
Documente Profesional
Documente Cultură
New Hire
Care of
Identification
IC Type (Passport/PAN/Driving License) Place of Issue
Date of Expiry
Identity Number (Passport / PAN No. / Driving License) (DD.MM.YYYY)
Spouse Child1
Relation* Please select... Please select...
First/Middle Name*
Last Name*
Birth date* (DD.MM.YYYY)
Gender* Please select... Please select...
Emergency Contact
Relation* Please select...
452259914.xlsx 14/14
First/Middle Name*
Last Name*
Address*
Contact Number*
**Please provide details of all educational & professional qualification attained starting with your first qualification
Only degree/diploma equivalent qualifications or higher are to be provided
Please attach copies of marks sheets & degree certificates for all education & professional qualification details mentioned below:
Record # 3 Record # 4
Degree Level* Please select... Please select...
Course Name (Please specify)
Education Type* Please select... Please select...
Educ. Institute Name*
Country* Please select... Please select...
City
Date Started* (DD.MM.YYYY)
Date of Completion* (DD.MM.YYYY)
ID/Roll Number
Work History
Record # 1 Record # 2
Employer*
Date from-to* (DD.MM.YYYY)
Position*
Functional* Please select... Please select...
City*
Country* Please select... Please select...
ID/Roll Number
If Temporary or Contractual, please provide name of agency
Reason for Leaving
Last Salary (CTC) Drawn / Current CTC
Details of Agency (if deployed from another agency / if
working on 3rd party
Name of Supervisor
Designation & Department of Supervisor
Supervisor's Contact No.
Supervisor's Email Id
Can a reference be taken now?
If 'No', please indicate date when reference can be taken
Record # 3 Record # 4
Employer*
Date from-to* (DD.MM.YYYY)
Position*
Functional* Please select... Please select...
City*
Country* Please select... Please select...
ID/Roll Number
If Temporary or Contractual, please provide name of agency
Reason for Leaving
Last Salary (CTC) Drawn / Current CTC
Details of Agency (if deployed from another agency / if
working on 3rd party
Name of Supervisor
Designation & Department of Supervisor
Supervisor's Contact No.
Supervisor's Email Id
Can a reference be taken now?
If 'No', please indicate date when reference can be taken
Please select (Yes/No) if the documents have been submitted for employment history:
452259914.xlsx 14/14
Please select... Others (please specify)
Please select... None
Blood Group
Former / Maiden Names (if applicable)
Date(s) of Name Change
Languages Known (Pls. specify):
Speak
Read
Write
References
Reference 1 Reference 2
Name
Contact No.
Email Id
Occupation (Provide details)
Relationship with the Referee
Years you have known the Referee
Other Information
Are you currently engaged in any other business either as a proprietor, partner, officer, director, trustee, employee, agent, retainer, contractor, consultant,
free lancer or otherwise. If yes, please give details.
Have you ever been dismissed from the services of any previous employer(s)? If yes, please give details.
Have you ever been convicted in a court of law or of a criminal offence? If yes, please give details and status of prosecutions against you.
Have you ever had any civil judgments made against you? If yes, please give details.
Have you ever been employed with Novartis Group of Companies? If yes, please give details.
Do you have any of your relatives employed in Novartis Group of Companies? If yes, please give details.
References
Please provide details of 2 references that may be contacted to obtain feedback.
Ensure that the references provided are not friends, members of your family or are current employees of Novartis Group of Companies
Reference 1 Reference 2
452259914.xlsx 14/14
Name
Contact No.
Email Id
Occupation (Provide details)
Comments
Requestor
Declaration: “I hereby declare that the information I have given is true and correct to the best of my knowledge. I understand that a misrepresentation or
omission of facts called for herein shall be sufficient cause for cancellation of consideration for employment or dismissal from the Company’s service if I
have been employed, without liability to the Company."
Associate Name
"I hereby authorize _________________________________________ Signature
(Company Name) and/or * to conduct verification of all statements
its agents its
contained in this record if I am considered for employment. I understand that my employment is subject to satisfactory background verification.”
452259914.xlsx 14/14
Background Verification Details Form
Associate's Data (As Per Country National ID Card)
Title*
Associate First Name*
Associate Middle Name
Associate Last Name*
Nationality by Birth *
2nd Nationality / Current
Nationality
Aadhar card number*
Care of
Identification
IC Type (Passport/PAN/Driving License)
**Please provide details of all educational & professional qualification attained starting with your first qualification
Only degree/diploma equivalent qualifications or higher are to be provided
Please attach copies of marks sheets & degree certificates for all education & professional qualification details mentioned below:
Name of Degree*
Course Name (Please specify)
Education Type*
Educ. Institute Name*
Country*
City
Date Started* (DD.MM.YYYY)
Date of Completion* (DD.MM.YYYY)
ID/Roll Number
Degree Level*
Course Name (Please specify)
Education Type*
Educ. Institute Name*
Country*
City
Date Started* (DD.MM.YYYY)
Date of Completion* (DD.MM.YYYY)
ID/Roll Number
Work History
Employer*
Date from-to* (DD.MM.YYYY)
Position*
Functional*
City*
Country*
ID/Roll Number
If Temporary or Contractual, please provide name of
agency
Reason for Leaving
Last Salary (CTC) Drawn / Current CTC
Details of Agency (if deployed from another agency / if
working on 3rd party
Name of Supervisor
Designation & Department of Supervisor
Supervisor's Contact No.
Supervisor's Email Id
Can a reference be taken now?
If 'No', please indicate date when reference can be taken
Employer*
Date from-to* (DD.MM.YYYY)
Position*
Functional*
City*
Country*
ID/Roll Number
If Temporary or Contractual, please provide name of
agency
Reason for Leaving
Last Salary (CTC) Drawn / Current CTC
Details of Agency (if deployed from another agency / if
working on 3rd party
Name of Supervisor
Designation & Department of Supervisor
Supervisor's Contact No.
Supervisor's Email Id
Can a reference be taken now?
If 'No', please indicate date when reference can be taken
Please select (Yes/No) if the documents have been submitted for employment history:
References
Name
Contact No.
Email Id
Occupation (Provide details)
Relationship with the Referee
Years you have known the Referee
Other Information
Are you currently engaged in any other business either as a proprietor, partner, officer, director, trustee, employe
free lancer or otherwise. If yes, please give details.
Please select...
Have you ever been dismissed from the services of any previous employer(s)? If yes, please give details.
Please select...
Have you ever been convicted in a court of law or of a criminal offence? If yes, please give details and status of p
Please select...
Have you ever had any civil judgments made against you? If yes, please give details.
Please select...
Have you ever been employed with Novartis Group of Companies? If yes, please give details.
Please select...
Do you have any of your relatives employed in Novartis Group of Companies? If yes, please give details.
Please select...
References
Please provide details of 2 references that may be contacted to obtain feedback.
Ensure that the references provided are not friends, members of your family or are current employees of Novartis Group
Name
Contact No.
Email Id
Occupation (Provide
details)
Relationship with the
Referee
Years you have known the Referee
Comments
Requestor
Declaration: “I hereby declare that the information I have given is true and correct to the best of my knowledg
or omission of facts called for herein shall be sufficient cause for cancellation of consideration for employment
service if I have been employed, without liability to the Company."
Associate Name
"I hereby authorize _________________________________________ (Company Name) and/or its agents to
contained in this record if I am considered for employment. I understand that my employment is subject to satis
und Verification Details Form
Please select...
Please select...
Please select...
Place of Issue
Date of Expiry
(DD.MM.YYYY)
Please select...
Record # 3 Record # 4
Please select... Please select...
Companies
pany has closed/ceased operations/moved location, do mention it
y
he employment preceding that
Record # 1 Record # 2
Reference 1 Reference 2
proprietor, partner, officer, director, trustee, employee, agent, retainer, contractor, consultant,
Details if Yes:
ious employer(s)? If yes, please give details.
Details if Yes:
nal offence? If yes, please give details and status of prosecutions against you.
Details if Yes:
Details if Yes:
Details if Yes:
Details if Yes:
obtain feedback.
your family or are current employees of Novartis Group of Companies
Reference 1 Reference 2
given is true and correct to the best of my knowledge. I understand that a misrepresentation
se for cancellation of consideration for employment or dismissal from the Company’s
mpany."