Employees

Permanent Employee Registration Form

Permanent Employee Registration Form at Corechamp Technologies Private Limited

User Registration - Step 1 of 13

Email *

Create Username *

Create your company "username" e.g "corechamp"

Create Password *

Password

Confirm Password

Create your "password" for login to core champ website

Applicant Information

“Applicant” means an individual person to sign agreement and receive the Services.

Name *

First

Last

Full Name of Applicant

Job Type/Tittle *

Date of Birth *

Date of Birth of Applicant

Gender *

Blood Group *

Marital Status *

Marriage Anniversary *

Aadhaar Number *

Aadhaar number of Applicant

Mobile number linked with AADHAAR *

Mobile number of Primary Member/Authorized Person

Upload Aadhar Card *

Click or drag a file to this area to upload.

Upload Aadhar Card of Applicant

PAN Number *

Please enter PAN number as mentioned in PAN Card of Applicant

Upload PAN Card *

Click or drag a file to this area to upload.

Upload PAN Card of Applicant

Permanent Residence Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Kindly enter address on which your Aadhar/Voter card is actual registered. it must be matched with your Govt Identity Proof

House Type *

Staying Since *

Living in Current City Since *

Current address is same as Permanent Residence Address? *

Current Present Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Kindly enter current address if current present address is different from Permanent Residence address

LinkedIn Profile Link *

linkedin.com/in/username

Facebook Profile Link *

facebook.com/username

Twitter Profile Link

twitter.com/username

Select Your Higher Qualification Type *

Course Name *

Course Type *

Stream *

For E.g ECE/Mechanical/CSE/IT

Course Start Date *

Course End Date *

College Name *

University Name *

Your Bank Detail

Please enter bank's detail

Account Beneficiary Name *

Kinldy enter name on which your account is opened in bank for example: Jithin Singh

Bank Account Number *

Kindly enter bank account number

IFSC Code *

Kindly enter IFSC Code

Bank Name *

Kindly enter Bank Name. E.g ICICI Bank

Family Members Details

Enter your Family Members Details

No. of Total Family Members Including you

Member 1

Full Name of Member 1 *

First

Last

Relationship with Member 1 *

Date of Birth of Member 1 *

Please mention D.O,B of your family member

Is Member 1 is Dependent on You? *

Is Family Member is dependent on you he/she will be covered in your group health insurance But dependent could b only (Wife, Son, Daughter)

Do you want to make member 1 your Emergency Contact Person? *

Emergency Contact Number of Member 1 *

Member 2

Full Name of Member 2 *

First

Last

Relationship with Member 2 *

Date of Birth of Member 2 *

Please mention D.O,B of your family member

is Member 2 Dependent on You? *

Is Family Member is dependent on you he/she will be covered in your group health insurance But dependent could b only (Wife, Son, Daughter)

You want to make member 2 your Emergency Contact Person? *

Emergency Contact Number of Member 2 *

Member 3

Full Name of Member 3 *

First

Last

Relationship with Member 3 *

Date of Birth of Member 3 *

Please mention D.O,B of your family member

Is Member 3 Dependent on You? *

Is Family Member is dependent on you he/she will be covered in your group health insurance But dependent could b only (Wife, Son, Daughter)

You want to make member 3 your Emergency Contact Person? *

Emergency Contact Number of Member 3 *

Member 4

Full Name of Member 4 *

First

Last

Relationship with Member 4 *

Date of Birth of Member 4 *

Please mention D.O,B of your family member

Is Member 4 Dependent on You? *

Is Family Member is dependent on you he/she will be covered in your group health insurance But dependent could b only (Wife, Son, Daughter)

You want to make member 4 your Emergency Contact Person? *

Emergency Contact Number of Member 4 *

Member 5

Full Name of Member 5 *

First

Last

Relationship with Member 5 *

Date of Birth of Member 5 *

Please mention D.O,B of your family member

is Member 5 Dependent on You? *

Is Family Member is dependent on you he/she will be covered in your group health insurance But dependent could b only (Wife, Son, Daughter)

You want to make member 5 your Emergency Contact Person? *

Emergency Contact Number of Member 5 *

Terms & Conditions

Employment General Terms & Condition *

I/We agree to the Applicant Details, Bank Account or Payment, Authorization and any applicable Terms & Conditions of Services Package Addendum in this Agreement.

• Incorrect Applicant details can lead to penalization or legal action

• Filing this form does not constitute and employment agreement, and this form submission is not to be
Constructed as a guarantee of employment by CORECHAMP Technologies for any period of time

• If your application accepted by us/company after
review, then only company will issue you offer letter/agreement

Custom Captcha *

Digital Signature by Applicant *

This is to assure that Applicant have filled this form

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This is a preview of your submission. It has not been submitted yet!
Please take a moment to verify your information. You can also go back to make changes.

Applicant Information

Your Bank Detail

Family Members Details

Member 1

Member 2

Member 3

Member 4

Member 5

Terms & Conditions

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