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Application For Employment Form 2022

This document is an application for employment at the University of Mpumalanga. It requests personal details, educational qualifications, work experience, references, health information, and a declaration from the applicant. Applicants must submit certified copies of qualifications and provide full consent for background checks. The application form is to be completed electronically and emailed to the provided recruitment email address.

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mpumelelobanda2001
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55 views7 pages

Application For Employment Form 2022

This document is an application for employment at the University of Mpumalanga. It requests personal details, educational qualifications, work experience, references, health information, and a declaration from the applicant. Applicants must submit certified copies of qualifications and provide full consent for background checks. The application form is to be completed electronically and emailed to the provided recruitment email address.

Uploaded by

mpumelelobanda2001
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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University of Mpumalanga

Cnr of R40 White River Rd and D725 Rd• Riverside•


Mbombela
Tel: (013) 002 0001
Website: www.ump.ac.za

APPLICATION FOR EMPLOYMENT


(a) A successful candidate who wilfully makes a false statement renders him/herself liable to instant dismissal.
(b) Certified copies of educational certificates and full CV must accompany the application form.
(c) Complete application must be email to [email protected]

If filling in this form electronically, please use the TAB key to move forward to next field and SHIFT TAB to move back.

1. VACANCY DETAILS

VACANCY NAME FOR WHICH YOU ARE APPLYING

DIVISION/ SCHOOL (if applicable)

2. PERSONAL DETAILS

Title (Prof/Dr/Mr/Mrs/Ms) Surname

Full names

Residential Address

Contacts
Contact Number 1

Contact Number 2
E-Mail address
PERSONAL DETAILS (Cont.)

Gender

Identity number/ Passport number

S A Citizen If NO, state which country


Yes: No:

Ethnic Group (African, White, Indian, Coloured, Other) - [For Statistical Reporting]

Disability If Yes, please specify:


Yes: No:

Valid driver’s licence Code


Yes: No:

Home language

Language Proficiency Speak Read Write


English

SiSwati

Other 1

Other 2

Other 3

Other 4

Other 5

Other 6
3. EDUCATIONAL DETAILS
Type of School
Year (Academic/Commercial/Tech
(a) Highest school grade passed obtained nical)

Name of school

Subjects passed
1. 5.

2. 6.

3. 7.

4. 8.

(b) Post-school qualifications completed (Please attach certified copies of educational qualifications)
Qualification Year Name of institution Major subjects

(c) Post-school studies currently in progress Expected date of completion Name of institution

Subjects passed
1. 4.

2. 5.

3. 6.

(d) Other appropriate training (e.g. courses)


Name of course Institution Date

(e)

Professional registrations/ Memberships


4. SERVICE RECORD (STARTING WITH PRESENT EMPLOYER)

Total
Period / Period
no Company name/ Employer Position held Years/ Reason for leaving
From To
Months

10

11
5. REMUNERATION

Present/Previous remuneration Per annum


Basic salary (Attach proof of salary) R

Bonus R

Allowance R

Housing benefit R

Car benefit R

Other (specify) R

TOTAL R

Incremental date:

6. GENERAL

Have you ever been found guilty of a criminal offence?


Yes No

If YES, kindly supply details

Do you have pending disciplinary actions against you


Yes No

Have you ever been dismissed from previous employment


Yes No

Do you give UMP consent to conduct background checks


Yes No

Notice period required at present employment

7. DECLARATION OF HEALTH

What is your present state of health?

Are there any health reasons that might prevent you from performing your duties effectively? Give details.

Name any other illness, sensory or physical defects you suffer from.
8. PROFESSIONAL REFERENCES (Not family)

1. Full Name 2. Full Name

Organization: Organization:

Contact no: Contac no:

Email: Email

Occupation/ Relationship Occupation/ Relationship

How long have you known this person? How long have you known this person?

3. Full Names 4. Full Names

Organization : Organization:

Contact: Contact:

Email: Email:

Occupation/ Relationship Occupation/ Relationship

How long have you known this person? How long have you known this person?
DECLARATION BY APPLICANT
I, ………………………………………………. hereby declare that the information I have shared on this application is correct
and give consent that references may be contacted, background checks can be undertaken, credentials and other
information may be verified by HR Practitioners at UMP and service providers contracted by UMP.

CONSENT IN TERMS OF THE PROTECTION OF PERSONAL INFORMATION ACT NO 4 OF 2013 1.


I declare that all the personal information completed by me on this form is true and correct, and I undertake to inform UMP of
any changes in my personal information.
I undertake to comply with all the rules, processes and policies and any amendments thereto. I have taken note of the
advice, which may be applicable to employees in general.
I, as a UMP staff or an applicant for employment at UMP, hereby consent that UMP may collect, use, distribute, process my
personal information for its business purposes, which may include, but not limited to:
• internal administrative processes pertaining to my employment at UMP,
• conducting criminal, credit and reference checks; and scholarly research.

SIGNATURE:___________________________________________DATE_____________________________

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