APLICATION FORM FOR EMPLOYMENT

REF. NO KFS/HRA/HRPR/01 - ISSUE NO. 001/10

A.) POSITION APPLIED FOR

1. Title_______________________________________________________________________

2. Ref. No_____________________________________________________________________

3. SALARY DETAILS

Description CURRENT (Ksh. Per month) EXPECTED (Ksh. Per month)

Basic Salary

Other Benefits (Specify)

B.) APPLICANT’S BIO DATA.

1. Name _____________________________ 2. ID Card/Passport No. __________________

2. Date of Birth: Day _______________Month ______________________Year____________

Page 1 of 1
3. PIN No_____________________________________________________________________

4. Place of Birth:

(a) County _______________________________________________________

(b) District _______________________________________________________

(c) Location ______________________________________________________

5. Addresses:

Permanent Address____________________________________________________________

Contact Address______________________________________________________________

E-mail Address_______________________________________________________________

Tel. No______________________________________________________________________

Mobile Tel. No________________________________________________________________

6. Marital Status: ____________________________________________________________

7. Next of Kin:

S/NO NAME ADDRESS TEL. NO RELATIONSHIP

C.) EDUCATION AND TRAINING

i.) Primary and Secondary Education: ( Indicate schools attended starting with the
highest)

Details of passes and

Year Year

Page 2 of 2
ii.) College and/or University Education

Name of College and/or Certificate/ Diploma /

Year Year

iii.) Any other courses attended.

S/NO INSTITUTION CERTIFICATE AWARDED DATES

NOTE: Attach photocopies of certificates from educational and /or training institutions
quoted above.

Page 3 of 3
D). EMPLOYMENT HISTORY

i.) List present and past employment, beginning with your most recent.

Name and address of

Company/ Organization. From To Position Salary Reason for leaving

Page 4 of 4
ii.) Any other additional experience and/or skills.
_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

E.) MEMBERSHIP TO PROFESSIONAL BODIES.

S/NO PROFESSIONAL BODY / INSTITUTION CATEGORY OF MEMBERSHIP

F.) REFEREES:

i.) Name__________________________________________________________________

Address________________________________________________________________

E –mail address_________________________________________________________

Tel. No_________________________________________________________________

ii.) Name__________________________________________________________________

Address_______________________________________________________________

E –mail address_________________________________________________________

Tel. No_________________________________________________________________

iii.) Name_________________________________________________________________

Address______________________________________________________________

E –mail address________________________________________________________

Tel. No_________________________________________________________________

Page 5 of 5
G.) i. HOBBIES______________________________________________________________

________________________________________________________________

ii. STRENGTHS___________________________________________________________

__________________________________________________________________

iii WEAKNESSES_________________________________________________________

_______________________________________________________________

iv. OUTSTANDING ACHIEVEMENTS__________________________________________

_____________________________________________________________________

I.) ADDITIONAL INFORMATION

i.) Have you ever been convicted at a court of law? ________________________________

ii.) If yes, please give details and judgment passed by the court on the offence.

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

J.) DECLARATION

The facts stated above are true to the best of my knowledge. I understand that if
employed, any false statement on this application form shall be considered sufficient
cause for dismissal.

I authorize you to make any investigation of my employment history.

_____________________ __________________________

Signature of applicant Date

Page 6 of 6