APPLICATION FOR EMPLOYMENT

APPLICATION FOR EMPLOYMENT
CONFIDENTIAL
PLEASE NOTE:
(a) Complete this form in your own handwriting using a black pen.
(b) A separate application form is required for each position applied for.
(c) Certified copies of relevant educational qualifications and certificates must be attached.
(d) All questions must be answered in full, including by current municipal employees.
(e) Incomplete or incorrect information may disqualify an applicant.
(f) Canvassing for appointment will disqualify the applicant.
(g) Current municipal employees must provide their personnel number.
INTERNAL APPLICANTS: PERSONNEL
NUMBER
Position applied for Reference number
PERSONAL PARTICULARS
Title Mr / Ms / Other: ____________________ Surname
First names (in full) Known as
Residential address Postal address
Postal code Postal code
Contact numbers Home: __________________ Work: __________________ Cell: __________________
Provide an alternative contact person if you cannot be reached at the numbers above.
Name Contact number
South African citizen? YES / NO Date of birth ____ / ____ / ______ Identity number
Home language Other languages
Language proficiency Good Fair Weak
Write
Read
Speak
Understand only
Driver's licence? YES / NO Date issued ____ / ____ / ______ Type
Have you ever been convicted of a criminal offence that may affect the position YES / NO
applied for?
Have you ever been found guilty of a disciplinary offence? If yes, provide details and YES / NO
date.
Enoch Mgijima Local Municipality
EMPLOYMENT EQUITY MONITORING INFORMATION
This information is required to enable the Municipality to comply with the Employment Equity Act, 1998.
Race
African / Coloured / Indian / White
Gender
Male / Female
Disability
YES / NO
If yes, provide details

EDUCATION
Name of school
Place Highest standard obtained Year

POST-SCHOOL EDUCATION
Name of institution and place Period attended Qualification obtained
From To

CURRENT STUDIES
If you are currently studying, provide full details.
Name of institution
Registration date Qualification and year of study

LEARNERSHIP / APPRENTICESHIP
Trade qualified in Date
Employer where learnership/apprenticeship was completed
Trade test
Passed / Did not write / Failed If passed, contract number and date

RECOGNITION OF PRIOR LEARNING
State clearly any relevant knowledge and skills linked to the advertised requirements.

Knowledge of
Skilled in

Membership of professional associations / institutes

Do you have any dependency regarding medication, alcohol, drugs, or similar substances? YES / NO
Do you have any health condition that may affect your job performance? YES / NO

Enoch Mgijima Local Municipality
WORKING EXPERIENCE
Are you presently employed? YES / NO Earliest date you can assume duties
CURRENT / LAST EMPLOYER
Employer name Address
Telephone number Position held
From: ____________
Nature of duties Period of service
To: ______________
Reason for leaving / change
PREVIOUS EMPLOYER
Employer name Address
Telephone number Position held
From: ____________
Nature of duties Period of service
To: ______________
Reason for leaving / change
PREVIOUS EMPLOYER
Employer name Address
Telephone number Position held
From: ____________
Nature of duties Period of service
To: ______________
Reason for leaving / change
CONTACTABLE REFERENCES
Name Position Company Telephone number
I hereby certify that the information provided above is, to the best of my knowledge, true and correct. I understand that, should my application be successful, any
material information found to be false or misleading may result in immediate dismissal. I confirm that all relevant information supporting my application has been
disclosed.
APPLICANT SIGNATURE DATE ____ / ____ / ______
Enoch Mgijima Local Municipality