Employee Job Application Word Document2
Employee Job Application Word Document2
ST RI CT LY CO NF ID EN T I AL
Post Advertised
in/on:
Section One
Have you been known by a different name or changed your name? Yes No
(If yes, please list below any reasonable adjustments you would request)
During the interview process: In carrying out the role for which you are applying:
Rehabilitation of Offenders
Having a criminal record will not necessarily disqualify you for this position.
References
Please supply most recent references.
Name: Name:
Address: Address:
Can we contact prior to interview? Yes No Can we contact prior to interview? Yes No
Section Two
Secondary Education
Name and location of establishment: From: To: Examinations taken Classification or Grade:
(including subject and level):
In date order, most recent first, with no gaps unaccounted for. Continue on a separate sheet if necessary.
(We may contact all or any employers you have listed below in order to verify the employment details stated.)
Name and address of Employer: Period Job title and brief description of role and Reason for leaving:
From: To: responsibilities:
Declaration
To the best of my knowledge I declare that the information contained in this application form is accurate and correct.
I understand and agree that:
a) The provision of false information may result in disqualification from the recruitment process or termination of
employment.
b) The information provided on this application may be stored and processed for a period of 6 months for recruitment
purposes and if successful the information will be stored on personal file and processed for the purpose of the
employment relationship.
c) Where I cannot provide evidence of qualifications, suitable references and / or the right to live and work in South
Africa the offer of employment may be rescinded and / or employment terminated.
d) Failure to disclose any convictions spent or otherwise will result in non appointment or disciplinary action and
potential dismissal.
e) All information contained in this form will be treated as strictly confidential, and used only for recruitment purposes.
By supplying information, you are indicating your consent to the information being processed for all employment
purposes and any verifications checks that may be made.
Date: Signature:
Equality & Diversity Monitoring Form
ST RI CT LY CO NF ID EN T I AL
Post Advertised in /
on:
Gender
Male Female Transgender Undeclared
Ethnic Origin (Please tick the box that you feel best describes your ethnic origin)
White
Mixed
Black
Date of Birth:
Employment
Jewish Muslim
Sexual Orientation
Undeclared