REPUBLIC OF SOUTH AFRICA

APPLICATION FOR EMPLOYMENT

WHAT IS THE PURPOSE OF

THIS FORM

To assist a government department

in selecting a person for an

advertised post.

This form may be used to identify

candidates to be interviewed. Since

all applicants cannot be

interviewed, you need to fill in this

form completely, accurately and

legibly. This will help to process

your application fairly.

WHO SHOULD COMPLETE

THIS FORM

Only persons wishing to apply for

an advertised position in a

government department.

ADDITIONAL INFORMATION

This form requires basic

information. Candidates who are

selected for interviews will be

requested to furnish additional

certified information that may be

required to make a final selection.

SPECIAL NOTES

1 – All information will be treated

with the strictest confidentiality and

will not be disclosed or used for

any other purpose than to assess the

suitability of a person, except in so

far as it may be required and

permitted by law. Your personal

details must correspond with the

details in your ID or passport.

2 – Passport number in the case of

non-South Africans.

3 – This information is required to

enable the department to comply

with the Employment Equity Act,

1998.

4 – This information will only be

taken into account if it directly

relates to the requirements of the

position.

5 – Applicants with substantial

qualifications or work experience

must attached a CV.

A. THE ADVERTISED POST

Position for which you are

applying (as advertised)

Department where the position

was advertised

Reference number (as stated in the

advert)

If you are offered the position

when can you start OR how

much notice must you serve

with your current employer?

B. PERSONAL INFORMATION (please ignore if you have attached a CV with ALL the following information)

Surname

First names

Date of birth

Identity number2

Race3 African White Coloured Indian

Gender3 Female Male

Do you have a disability?3 Yes No

Are you a South African citizen? Yes No

If no, what is your nationality?

And do you have a valid work permit? Yes No

Have you been convicted of a criminal offence

or been dismissed from employment?4

Yes No

If your profession or occupation requires State

or official registration, provide date and

particulars of registration

C. HOW DO WE CONTACT YOU

Preferred language for correspondence

Telephone number during office hours Preferred method for

correspondence

Post E-mail Fax

Correspondence contact

details (in terms of the

above)

Languages (specify)

Speak

Read

Write

E. QUALIFICATIONS5 (please ignore if you have attached a CV with these details) Name of School/Tertiary College

Highest qualification obtained Year obtained

Tertiary education (complete for each qualification you obtained) Name of Institution Name of qualification Year obtained Current study (institution and qualification):

F. WORK EXPERIENCE5 (please ignore if you have attached a CV with these details) Employer (including Post held From To Reason for

leaving

current employer) MM YY MM YY

If you were previously employed in the Public Service, indicate whether any condition exists that prevents your re-appointment.

Yes No

G. REFERENCES (please ignore if you have attached a CV with these details) Name Relationship to you Tel. No. (office hours)

DECLARATION

I declare that all the information provided (including any attachments) is complete and correct to the best of my knowledge. I understand that any false information supplied could lead to my application being disqualified or my discharge if I am appointed. Signature :

Date:

Contact this candidate