G.P.S 81/971431

Republic of South Africa

APPLICATION FOR EMPLOYMENT

Z83 (81/971431)

Effective 01 January 2021

WHAT IS THE PURPOSE OF THIS FORM

To assist a government department in selecting a person for an advertised post. This form may be used to identify candidates to be interviewed. You need to fill in all sections of this form completely, accurately and legibly. This will help to process your application fairly.

WHO SHOULD COMPLETE THIS FORM

Only persons wishing to apply for an advertised position in a government department.

ADDITIONAL INFORMATION

This form requires basic information. Candidates who are selected for interviews will be requested to furnish additional certified information that may be required to make a final selection.

SPECIAL NOTES

  • 1 – All information will be treated with the strictest confidentiality and will not be disclosed or used for any other purpose than to assess the suitability of a person, except in so far as it may be required and permitted by law. Your personal details must correspond with the details in your ID or passport.
  • 2 – Passport number in the case of non-South Africans.
  • 3 – This information is required to enable the department to comply with the Employment Equity Act, 1998.
  • 4 – This information will only be taken into account if it directly relates to the requirements of the position.
  • 5- The Executive Authority shall consider the criminal record (s) against the nature of the job functions in line with internal information security and disciplinary code.
  • 6- The applicant may submit additional information separately where the space provided is not sufficient.
  • 7- Departments must accept certified documents that accompany the application(s) with certification that is up to 6 months, unless the advert prescribes a longer period.
  • 8- Each application for employment form must be duly signed and initialed by the applicant. Failure to sign this form may lead to disqualification of the application during the selection process.
A. THE ADVERTISED POST (All sections of this form are compulsory)
Reference number (as stated in the advert)
Department where the position was advertised
Position Name
If you are offered the position, when can you start OR how much notice must you serve with your current employer?
B. PERSONAL INFORMATION1
Surname
Full names
Date Of Birth
Identity Number (Required if SA citizen)
Passport number
Ethnicity*
Gender*
Do you have a disability?
Are you a South African citizen?
Have you been convicted or found guilty of a criminal offence (including an admission of guilt)?
Do you have any pending criminal case against you?
Have you ever been dismissed for misconduct from the Public Service?
Do you have any pending disciplinary case against you?
Have you resigned from a recent job pending any disciplinary proceeding against you?
Have you been discharged or retired from the Public Service on grounds of Ill-health or on condition that your cannot be re-employed?
Are you conducting business with the State or are you a Director of a Public or Private company conducting business with the State?
In the event that you are employed in the Public Service, will you immediately relinquish such business interests?
Please specify the total number of years of experience you have
Public Sector
Private Sector
If you were previously employed in the Public Service, is there any condition that prevents your re-appointment
If your profession or occupation requires official registration, provide date and particulars of registration
Date
Institution Name
Reg No
C. CONTACT DETAILS AND MEDIUM OF COMMUNICATIONS
Preferred language for correspondence
Email
Contact Number / Mobile Number
(eg. 0123125911)

D. SOUTH AFRICAN OFFICIAL LANGUAGE PROFICIENCY – state ‘good’, ‘fair’, or ‘poor’

Language
Language Name
Speak Proficiency
Write and Read Proficiency

E. FORMAL QUALIFICATION7 (from highest to the lowest)

Name of Institution
Name of Institution
Name of qualification obtained
Student Number
Year obtained
Status

F. WORK EXPERIENCE (Also attach a detailed CV)

Employer
Employer Name
Post held
From
To
Status
Reason for leaving

G. REFERENCES

References
Name of reference
Relationship to you
Contact Number (Office Hours)

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 provided will result in my application being disqualified or disciplinary action taken against me if I am appointed:
I agree
Date
Signature

Add Supporting Documentation

This should include the below documents:

CV (Compulsory)

ID/Passport (Compulsory)

Qualification (Compulsory)

Drivers License (if applicable)

Additional Information/References (at least 3 references if not already provided in Section G)