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The document is an application form for employment in a government department, designed to assist in selecting candidates for an advertised position. It requires personal information, qualifications, work experience, and references, while ensuring confidentiality and compliance with the Employment Equity Act. Applicants must declare the accuracy of their information and may need to provide additional certified documentation if selected for an interview.

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musa
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3 views

Z83_form filled1

The document is an application form for employment in a government department, designed to assist in selecting candidates for an advertised position. It requires personal information, qualifications, work experience, and references, while ensuring confidentiality and compliance with the Employment Equity Act. Applicants must declare the accuracy of their information and may need to provide additional certified documentation if selected for an interview.

Uploaded by

musa
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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Application for Employment

WHAT IS THE PURPOSE OF THIS A. THE ADVERTISED POST


FORM

To assist a government department Position for which you are applying Department where the position was
in selecting a person for an (as advertised) advertised
advertised post.

This form may be used to identify


candidates to be interviewed. Reference number (as stated in the If you are offered the position,
Since all applicants cannot be advert) when can you start OR how much
interviewed, you need to fill in this notice must you serve with your
form completely, accurately and current employer?
legibly. This will help to process
your application fairly.

WHO SHOULD COMPLETE THIS


FORM

Only persons wishing to apply for


B. PERSONAL INFORMATION
an advertised position in a
government department.
Surname Mbata
ADDITIONAL INFORMATION
First Names Musa
This form requires basic
information. Candidates who are
selected for interviews will be
Date of Birth 1994/09/22
requested to furnish additional
2
certified information that may be ID number 9409220275089
required to make a final selection.
3
Race African White Coloured Indian
SPECIAL NOTES
3
1 – All information will be treated Gender FEMALE MALE
with the strictest confidentiality
and will not be disclosed or used 3
Do you have a disability? YES NO
for any other purpose than to
assess the suitability of a person,
except in so far as it may be Are you a South African Citizen? YES NO
required and permitted by law.
Your personal details must If no, what is your
correspond with the details in your Nationality
ID or passport. And do you have a valid work
YES NO
Permit?
2 – Passport number in the case of
non-South Africans. Have you ever been convicted of a
criminal offence or been dismissed YES NO
3 – This information is required to form employment? 4
enable the department to comply
with the Employment Equity Act, If your profession or occupation
1998. requires State or official
registration, provide date and
4 – This information will only be particulars of registration.
taken into account if it directly
relates to the requirements of the
position.

5 – Applicants with substantial C. HOW DE WE CONTACT YOU


qualifications or work experience
must attach a CV. Preferred language for correspondence? English
Telephone number during office hours ( 27) 833059870
Preferred method for
Post E-mail Fax
correspondence
Correspondence contact
details (in terms of above) Musa Mbata
D. LANGUAGE PROFICIENCY – state ‘good’, ‘fair’ or ‘poor’
Languages (specified)
isiZulu English sePedi siXhosa Afrikaans
Speak x x x x x
Read x x x x
Write x x x x

E. QUALIFICATIONS 5 (please ignore if you have attached a CV with these details


Name of School / Technical College Highest qualification obtained Year
Obtained

Tertiary education (complete for each qualification you obtained)


Year
Name of Institution Name of Qualification
Obtained
Services SETA N4 Project Management 2012
University Of Johannesburg BEng Civil Engineering (HONS) 2018
University Of Johannesburg MEng in Civil Engineering (RD) In Progress

Current study (institution and qualification)

5
F. WORK EXPERIENCE (please ignore if you have attached a CV with these details)
Employer (including From To Reason for
Post held
current employer) MM YY MM YY Leaving

If you were previously employed in the Public Service, indicate whether


YES NO
any condition exists that prevents your re-employment
If yes, provide the name of the previous employing
department

G. REFERENCES (please ignore if you have attached a CV with these details)


Name Relationship to you Tel. No. (office hours)
Marista Potegier Manager
Johannes Bester Research Supervisor
Innocent Mkoma Mentor

DECLARATION
I declare that all the information provided (including any attachments) is complete and
correct to the best of my knowledge. I understand that any false information supplied
could lead to my application being disqualified or my discharge if I am appointed.

Signature: Date:
19/02/2020

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