1 A. THE ADVERTISED POST (All sections of this form are compulsory) 2 B. PERSONAL INFORMATION Step description 3 C. CONTACT DETAILS AND MEDIUM OF COMMUNICATIONS Step description 4 D. SOUTH AFRICAN OFFICIAL LANGUAGE PROFICIENCY state ‘good’, ‘fair’, or ‘poor’ 0% Position for which you are applying (as advertised Department where the position was advertised Reference number (as stated in the advert) If you are offered the position, when can you start OR how much notice must you serve with your current employer? What is job reference number? Upload CV Upload Job Advert Upload Z83 Submit Previous Next Full Names Surname Date of Birth ID Number Passport Number Race African White Coloured Indian Other Gender Female Male Do you have a disability? Yes No Are you a South African citizen? Yes No If no, what is your nationality? Do you have a valid work permit? (only if non-South African) Yes No Have you been convicted or found guilty of a criminal offence (including an admission of guilt)? Yes No If yes (provide the details) Do you have any pending criminal case against you? Yes No If yes, (provide the details) Have you ever been dismissed for misconduct from the Public Service? Yes No If yes (provide the details) Do you have any pending disciplinary case against you? Yes No If yes, (provide the details) Have you resigned from a recent job pending any disciplinary proceeding against you? Yes No If yes, (please note that the provisions of the Public Service Act shall apply). Have you been discharged or retired from the Public Service on grounds of Ill-health or on condition that your cannot be re- employed? Yes No Are you conducting business with the State or are you a Director of a Public or Private company conducting business with the State? If yes, (provide the details) Yes No In the event that you are employed in the Public Service, will you immediately relinquish such business interests? Yes No Please specify the total number of years of experience you have Private Sector Public Sector Date - PRS If your profession or occupation requires official registration, provide date and particulars of registration Reg. No - PUS If your profession or occupation requires official registration, provide date and particulars of registration Previous Next Preferred language for correspondence Method for correspondence Post E-mail Fax Telephone Contact details (in terms of the above) Previous Next Repeater Speak Good Fair Poor Repeater Languages (specify) Speak Good Fair Poor Read Good Fair Poor Text Previous Next
