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APPLICATION FOR EMPLOYMENT FORM

Please complete this form in block letters as appropriate and submit together with your national identity card, detailed CV,
copies of professional and academic certificates and testimonials to the Director General, Public Procurement Regulatory
Board, Email [email protected] P.O. Box 58535-00200 Nairobi, KENYA. Each copy must be self- certified by yourself
that it’s a true copy of the original

1. Position Applied for

Vacancy/Position……………………………………………………………………………………………...Ref………………………………………………..

2. Personal Details

Name of the applicant…………………………………………………………………… ………………………………………….Title………………………….

(Surname) (First Name )(Other Names)(Prof/Dr/Mr./Mrs./Ms/Rev)

Date of Birth & Age……………………………………………………………………………….. Gender: Male Female

(dd-mm-yyyy/years)

Nationality:…………………………………ID/Passport No:………………………………………….Employment/PNo………………………………

NSSF No……………………………………….NHIF NO……………………………………………………KRA PIN NO………………………………………….

Address:…………………………………………………………………………………………….Postal Code:…………………………………………………….

Nationality:……………………………………Home County…………………………………….Sub-county :………………………………….

Constituency ………………………………………………………………………………………..Ethnicity:………………………………………………..

Telephone:…………………………………………..Mobile:………………………………………..E-Mail Address:…………………………………………

Alternative Contact Person:……………………………………………………………………………..Telephone:…………………………………………

Marital Status: Single Married Divorced Widow(er) Separated

C C

SIGNED……………………………………………………………………………..DATE………………………………………………………………
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Are you living with Disability? Yes No

If yes, give;

(i) Details/Nature of Disability:………………………………………………………………………………………………...………………….........

(ii) Details of Registration with the National Council for People with Disabilities (Registration No. and
date)..................................................................

3. Applicants in the Public Service Only

Ministry/State Department/ County/Other Public Institutions:……………....……………………………………………………….

Station:…………………….…........... Personal/Employment No:……………………….….….…… Present Substantive
Post:………………………………………......................................... Job group/Scale/Grade:………...........................

Date of Current Appointment (dd-mm-yyyy).......……….................... Upgraded post (where

applicable):…………………………………………… effective date of previous appointment:……………………………......... (dd-mm-
yyyy)

On Secondment (where applicable): Organization:.......................................................

Designation:.............................................Job Group/Grade……….................................

Terms of Service: Permanent & Pensionable

Contract

Other, Please specify:.........................................................

4. Applicants in Private/NGO/Other Sectors – Current appointment Information

Current employer:……………………………………………………………………..……Position held:…………………….……………………………….

Current position appointment date:………………………………………….. Salary (Monthly) Ksh…..…………………………………………

5. Other Details

Indicate all the language(s) that you are proficient in………………………………………………………………………………………………..

Do you suffer from any medical or physical impairment? Yes No

If yes give details:………………………………………………………………………………………………………………………………………………………….

Have you ever been convicted of any criminal offences or a subject of probation order? Yes No

Have you ever been dismissed or otherwise removed from employment? Yes No

SIGNED……………………………………………………………………………..DATE………………………………………………………………
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Are you a subject of any on-going investigation by EACC? Yes No

If yes state, state reason(s) for dismissal/removal/Investigation……………………………………………………..effective

date………………………

(dd-mm-yy)

DO YOU HAVE ANY FAMILY MEMBERS/RELATIVES WORKING OR ARE BOARD MEMBERS IN PPRA?

YES NO

IF YES, GIVE NAME, RELATIONSHIP…………………………………………………………………………………………………

(Declaring the above information will not necessarily debar an applicant from employment. Each case will be
considered on its own merit)

6. Academic/Professional/Technical Qualification(Starting with the Highest)

Year University/College/Instituti Award/Attainment Courses Specialisatio Class/Grade

on/school n/Subject
(e.g. Degree, (e.g. PhD,
Diploma, Certificate) Msc., BA) (Economics,
Math e.t.c)

From To

SIGNED……………………………………………………………………………..DATE………………………………………………………………
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7. 7 Professional/Technical Qualifications/Certifications Relevant to the post. (Starting with the Highest)

Year Institution/College Award/Attainment (e.g. Higher Specializa Class/Grade

Diploma, Diploma, Certificate) tion/Subj
ect (e. g
Human
Resource,
Engineeri
ng,
Counselli
ng e.t.c)

FROM TO

8. Relevant Courses and Training attended Lasting not Less than One (1) Week

Year University/college/instituti Name of the Course Details and duration

on

9. Current registration/Membership to professional Body (including practicing license if applicable)

SIGNED……………………………………………………………………………..DATE………………………………………………………………
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Professional Membership/Registration Membership type (e.g. Date of Renewal

Body No./Practicing Certificate Associate, Full etc)

10. Employment Details (starting with the most recent)

Year Employer’s Position/Rank/Designation Job Group/Gross Reason for leaving

Name Monthly Salary(Ksh.)

From To

11. Briefly state your current duties, responsibilities and assignments

………………………………………………………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………………………………………………………
………………………………………………………………………

12. Please give the details of your abilities, skills and experience which you consider are relevant to the position
applied for. The information may include an outline of your most recent achievements and your reason for
applying.…………………………………………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………………………………………………………

SIGNED……………………………………………………………………………..DATE………………………………………………………………
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………………………………………………………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………………………………………………………
…………

13. Personal References

Give the names and addresses of three referees. They should be responsible persons who know you well; one at least
should be well acquainted with you in private life AND the others should be your 2 immediate previous employers, where
applicable. The names of distinguished persons should not be used unless they know you well and they have consented.
The names of relatives or those from whom you send testimonials should not be given; nor should the names of members
of the board or staff of the Public Procurement Regulatory Authority.

1. Full Name:………………………………………………………………………………………………………………………………………………………………

Address:………………………………………………………………………………………………………………………………………………………………….

Telephone No:…………………………………………………..Email Address:…………………………………………………………………………….

Occupation:……………………………………………………………………………………………………………………………………………………………

Period for which he/she has known you:………………………………………………………………………………………………………………..

2. Full Name:………………………………………………………………………………………………………………………………………………………………

Address:………………………………………………………………………………………………………………………………………………………………….

Telephone No:…………………………………………………..Email Address:…………………………………………………………………………….

Occupation:……………………………………………………………………………………………………………………………………………………………

Period for which he/she has known you:………………………………………………………………………………………………………………..

3. Full Name:………………………………………………………………………………………………………………………………………………………………

Address:………………………………………………………………………………………………………………………………………………………………….

Telephone No:…………………………………………………..Email Address:…………………………………………………………………………….

Occupation:……………………………………………………………………………………………………………………………………………………………

Period for which he/she has known you:………………………………………………………………………………………………………………..

PPRA MAY SEEK REFERENCES FROM YOUR PRESENT/MOST RECENT EMPLOYER (3) WHEN AN OFFER IS BEING CONSIDERED. KINDLY SPECIFY
IF YOU WOULD HAVE ANY OBJECTION AND THE REASON.

SIGNED……………………………………………………………………………..DATE………………………………………………………………
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……………………………………………………………………………………………………………………………………………………………………………………………………………………
……………………………………………………………………………………………………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………………………………………………………………………………………..

WHAT ARE YOUR REMUNERATION EXPECTATIONS? (SALARY, BENEFITS AND ALLOWANCES)

Remuneration per Month Ksh

Basic Salary ……………………………

House Allowance ……………………………

Other Remunerative Allowances ……………………………

Gross ……………………………

Mobile Phone Airtime ……………………………

Leave traveling allowance ……………………………

Other Benefits

No of leave days per year ……………………………

Pension arrangements: ……………………………

Employer rate of contribution ……………………………

Employee rate of contribution ……………………………

Medical cover
………………………………………………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………………………………………………

………………………………………………………………………………………………………………………………………………………………………

WHEN WOULD YOU BE AVAILABLE TO TAKE UP AN APPOINTMENT? (External Candidates only)

……………………………………………………………………………………………………………………………………………………………………………………

SIGNED……………………………………………………………………………..DATE………………………………………………………………
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ARE YOU TAX COMPLIANT? (COPY OF TAX COMPLIANT CERTIFICATE WILL BE REQUIRED AS PROOF WHEN AN OFFER IS BEING CONSIDERED)

YES NO

DO YOU HAVE A HELB LOAN? (YOU WILL BE REQUIRED TO PROVIDE PROOF WHEN AN OFFER IS BEING CONSIDERED)
YES NO

HAVE YOU EVER BEEN FOUND GUILTY OF THE VIOLATION OF ANY LAW (OTHER THAN MINOR TRAFFIC VIOLATIONS)?
YES NO

IF YES, PLEASE INDICATE THE CHARGE, DATE, PLACE OF TRIAL, AND DECISION/JUDGEMENT. (A CURRENT POLICE CLEARANCE CERTIFICATE WILL BE
REQUIRED AS PROOF WHEN AN OFFER IS BEING CONSIDERED).

DECLARATION

I CERTIFY THAT THE STATEMENTS MADE BY ME IN ANSWER TO THE FOREGOING QUESTIONS ARE TRUE, COMPLETE AND CORRECT TO THE BEST OF MY
KNOWLEDGE AND BELIEF. I UNDERSTAND THAT ANY FALSE STATEMENTS OR FACTUAL OMISSIONS FROM THIS FORM MAY BE HELD AGAINST MY
CANDIDATURE AND/OR MAY PROVIDE GROUNDS FOR DISCIPLINARY MEASURES.

Date:……………………………………………………… ……………………………………………………………….

(dd-mm-yyyy) Signature of the Applicant

Note:

1. The information provided will be used by PPRA and any external recruitment consultant and/or organization
appointed by PPRA to help in the recruitment process. The information in relation to your application and
this recruitment process will be held on both electronic and paper format.

2. PPRA reserves the right to independently verify any information provided and or enquire further as may be
deemed necessary

SIGNED……………………………………………………………………………..DATE………………………………………………………………