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APPLICATION FORM Updated Version

The application form is for candidates applying for advertised positions with the Winnie Madikizela-Mandela Local Municipality. It requests personal and contact details, qualifications, work experience, and disclosure of any disciplinary or criminal history. Candidates are informed that all information provided will be kept confidential and used only to assess their suitability for the position.

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Simamkele
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79 views

APPLICATION FORM Updated Version

The application form is for candidates applying for advertised positions with the Winnie Madikizela-Mandela Local Municipality. It requests personal and contact details, qualifications, work experience, and disclosure of any disciplinary or criminal history. Candidates are informed that all information provided will be kept confidential and used only to assess their suitability for the position.

Uploaded by

Simamkele
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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WINNIE MADIKIZELA-MANDELA

LOCAL MUNICIPALITY

APPLICATION FORM FOR EMPLOYMENT


TERMS AND CONDITIONS
1. The purpose of this form is to assist the Municipality in selecting suitable 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 a CV.
3. Candidates shortlisted for an interview may be requested to furnish additional information
that will assist the Municipality to expedite the recruitment and selection process.
4. All information received shall be treated with strict confidentiality and will not be used for
any other purpose than to assess the suitability of the applicant.
5. This form is designed to assist the Municipality with the Recruitment, Selection and
Appointment of Staff members in terms of the Local Government: Systems Act, 2000
(Act No 32 of 200).

A. DETAILS OF THE ADVERTISED POST (as reflected on the advert)


Advertised post applying for
Source of Advert
Reference Number
Notice Service Period

B. PERSONAL DETAILS
Surname

APPLICATION FORM FOR EMPLOYMENT 1


First Names

ID/Passport Number

Race African Coloured Indian White

Gender Female Male

Do you have any disabilities Yes No

If yes, elaborate

Are you a South African citizen Yes No

If no what is your nationality

Work Permit Number (if any)

Do you hold any political office in a political party, whether in a permanent,


temporary
Or acting capacity. If yes, provide information below
Political Party: Position: Expiry date:

Do you hold a professional membership with a professional body? If yes, No


provide
Information below:

Professional Body: Membership No: Expiry Date:

C. CONTACT DETAILS
Preferred language of
communication

Telephone number during office ( )


hours:

Mobile
Number/s
Preferred method for SMS Email Post
correspondence
Postal
address

Code:

Email Address

APPLICATION FORM FOR EMPLOYMENT 2


D. QUALIFICATIONS (please elaborate on your CV)
Name of School Highest Qualification Year Obtained

Name of the institution Name of qualification NQF Level Year Obtained

E. WORK EXPERIENCE (Additional information may be provided on your CV)


Employer (starting with Position From To Reason for
With the most recent leaving
MM YY MM YY

If you previously employed in Local Government, Yes No


indicate
Whether any condition exists that prevents your re-
employment:
If yes, provide the name of
the employing municipality

F. DISCIPLINARY RECORD
Have you been dismissed for misconduct? Yes No
If yes, name of Municipality/Institution

Type of misconduct/transgression

Date of resignation/disciplinary case finalised

Award/Sanction

Did you resign from your job pending the finalisation of


the disciplinary proceedings? If yes provide details on a
separate sheet.

APPLICATION FORM FOR EMPLOYMENT 3


G. CRIMINAL RECORD
Were you convicted of a criminal offence involving financial Yes No
misconduct, fraud or corruption? If yes, provide details on
a separate sheet.
If yes, type of criminal act

Date criminal act was


finalised
Outcome/Judgement

H. REFERENCE (please elaborate on your CV)


Name of referee Relationship Tel (office Cellphone No. E-mail
hours)

I. DECLARATION
I hereby declare that all the information provided in this application and any attachments in
support thereof is to the best of my knowledge true and correct. I understand that any
misrepresentation or failure to disclose any information may lead to my disqualification or
termination of employment of contract, if appointed.
Signature: Date:

APPLICATION FORM FOR EMPLOYMENT 4

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