Employee Application Form-Revised
Employee Application Form-Revised
This form has been designed to provide us with basic information for processing your
application. It will serve as a personal record should you be employed.
Please read the form carefully before attempting to complete it. Photocopied certificates
should be attached with this application.
Declaration
I declare that all information given herein is true and correct to the best of my
knowledge. I understand that any misrepresentation or omission of facts will be
sufficient cause for cancellation of consideration for employment or dismissal from the
Institute’s service if I have been employed. I also authorise any investigation of the
information provided herein for purpose of verification.
__________________________ ______________________
Signature of Applicant Date
Please affix
Photograph
PERSONAL PARTICULARS
Name: Other Names:
1/5
Nature/Dates of
serious illness (if
any):
FAMILY DETAILS
Spouse’s/Parents* Name: Occupation: No of children:
M: F:
Name of Sex Age Occupation Name of Firm/School
children/siblings*
EMERGENCY CONTACT
Name: Telephone Numbers
Address: Home
Office
Relationship: Mobile
EDUCATION DETAILS
Level Name of Year Name of Course Results
Schools/Institutions From - To Achieved
Secondary
Tertiary
Other
2/5
3/5
EMPLOYMENT RECORD
(Please indicate each major position held within the same company)
Employer & Address Position Held/ Brief Description of Job Reason For
Month/ Year Basic Salary
Reporting To Leaving
From To Initial Last
Drawn
4/5
REFERENCE
Name Company / Tel No Occupation/ Years known
Relationship
COURSES ATTENDED
Title of Course Organiser Duration
OTHER INFORMATION
Any other information you would consider important and helpful to us in
assessing your suitability for the appointment you have applied for
5/5