EXTERNAL APPLICATION FORM
TERMS AND CONDITIONS
1. The purpose of this form is to assist the municipality in selecting candidates for an advertised post.
2. This form must be completed in full, accurately and legibly. All substantial information relevant to a candidate must be provided in this form. Any additional
information may be provided on the CV.
3. All information received will be treated with strictly confidentiality and will not be used for any other purpose than to assess the suitability of the applicant
COMPLETE THIS FORM
POSITION APPLIED FOR: ……………………………………………………………………..……
DEPARTMENT: ………………………………………………………………………………………..
NOTICE SERVICE PERIOD…………………………………………………………………………...
A. PERSONAL PARTICULARS:
1. Tittle and Surname (Mr. / Ms.):……………………….. First names:………………………………………………………
2. Postal Address:………………………………………………………… Code:…………………………………………………
3. Residential Address :………………………………………………………………………………………………………………
4. Telephone: (Home):……………… (Work): ……………. (Cellphone): ………………………………………………………..
5. Identity Number:…….…….…………………..… Driver’s License Code(s):………………………………………………….
6. Email Address: ……………………………………………………………………………………………………………………..
7. Race: (Tick Appropriate Box) AFRICAN COLOURED INDIAN WHITE
8. Gender:
MALE FEMALE
9. Are you a South African Citizen? If not,
YES NO
specify………………………………………….
10. Do you have a valid work permit:
YES NO
11. Do you hold a professional membership with any professional body: YES
NO
Name of professional body……………………………………………...…….…… Expiry date……………………………
B. SCHOOL EDUCATION:
1. Name of School: …………………………………………………………………………………………………...…………
Highest Standard: ……………………………………….……….……… Year Passed………………….…………….
#PLEASE ATTACH A COPY OF HIGHEST STANDARD CERTIFICATE TO APPLICATION.
C. TERTIARY QUALIFICATION:
1. Name of Institution: …………………………………………... Year obtained: ……………………………..
Highest Degree/ Diploma/ Certificate obtained: …………………………… NQF level: ………………………………
#PLEASE ATTACH COPY OF DEGREE / DIPLOMA/CERTIFICATE TO APPLICATION
D. LANGUAGE PROFICIENCY:
1. English: Speak: ……………. Other……... Speak: ……………………
Write: …………… Write: ……………………
Read: …………… Read: ……………………...
Preferred method for correspondence: SMS OR EMAIL ………………………………………………………..…...
E. PREVIOUS EMPLOYMENT (start with the most recent)
1. Additional Information may be attached.
Name of Employer From To Job title at Job title at Reason for
Employment Resignation Termination
F. WORK REFERENCES (Indicate with *if may be contacted)
No. Name Address Tel Occupation
1.
2.
3.
G. GENERAL
1. Do you have any criminal record? YES NO
2. Please provide particulars if you have been found guilty of any criminal offence:
……………………………………………………………………………………………………………………………………………
……………………………………………………………………………………………………………………………………………
Please indicate if you have any disability:
YES NO
Please specify………………………………………………………………………………………………….
H DISCIPLINARY RECORD:
1. Have you been dismissed for misconduct during the past ten (10) years: YES NO
2. If yes, name of Organisation……………..…………………………………………………………………….
3. Type of misconduct / Transgression…………………………………………………………..……………..
4. Date of resignation / Disciplinary case finalized / Dismissal: …………………………………………….
Award / Sanction: ……………………………………………………………………………………………..
5 Have you been accused of an alleged misconduct and resigned from your job pending finalization of disciplinary
proceedings?
YES NO
I certify that the above particulars are to the best of my knowledge true and correct
SIGNATURE…………………................. DATE:………………………………..
# FAILURE TO ATTACH REQUIRED DOCUMENTS WILL RESULT IN YOUR APPLICATION BEING DISQUALIFIED
DECLARATION
I, hereby declare that all the information provided in this application form and my attachments in support thereof is to the best of my knowledge true and
correct. I understand that any misinterpretation or failure to disclose any information may lead to my disqualification or termination of my employment
contract if appointed.
Signature:……………………………………… Date: …………………………………………
