Marius Scheepers and Company
Attorneys
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Form H - Job Application Form
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Position applied for: Date: Have you previously applied to.........................................for employment? PERSONAL PARTICULARSSurname: Full first names: Known as: Postal address: Residential address: Phone numbers: Home: Work: Contact name Nationality: . If not South African, do you have:
If yes, type of permit and date of expiration: Do you have a criminal record? (Yes/No) If yes, state offences: Do you have a valid driver's licence? (If position requires) (Yes/No) Code: Do you have your own car? (If position requires) (Yes/No) If no, state means of transport: Are you computer literate (If position requires) (Yes/No)? If yes, list computer packages: Indicate, by drawing a cross in the appropriate column, your ability to speak, read and write the following languages (only if the position requires):
SECONDARY EDUCATIONLast school attended: Highest Standard passed: Year : Subjects passed at the time of last written examination:
TERTIARY EDUCATIONInstitution: Qualification obtained:
Year: Major subjects: Institution: Qualification obtained: Year: Major subjects: Other: Present studies: JOB RELATED TRAINING COURSESCourse: Period: Course: Period: Course: Period: EMPLOYMENT HISTORYPresent position: Company: Period of employment: Salary: Benefits: Annual leave: Notice period: Duties: Did you have staff reporting to you? (Yes/No) If yes, what positions did they hold?
Who did you have to report to?
Can we contact your present employer for a reference (Yes/No)? If yes, provide the name of a referee:
Phone number: PAST EMPLOYMENT
REFERENCES
MEMBERSHIP OF PROFESSIONAL ASSOCIATIONS
I declare that the information is true and complete in all aspects. I understand that any misrepresentations or omission may be considered sufficient for withdrawal of any offer, or subsequent dismissal from employment.
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Compiled by M. Scheepers
This manual is copyright under the Berne Convention. In terms of the Copyright Act, No. 98 of 1978, no part of this manual may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording or by any information storage and retrieval system, without permission in writing from the author.
