Ministry of Economy

[Pages:3]CONFIDENTIAL APPLICATION FOR EMPLOYMENT/RECORD FORM

POSITION APPLIED FOR:

VACANCY NUMBER:

ATTACHMENTS REQUIRED 1. Cover letter 2. Recent Curriculum Vitae 3. Certified copy of Transcript (s), Certificate (s)

Surname: Nationality: FNPF No: Home Address: Phone No.: (Home) Driving License Number:

(Work)

(PERSON TO BE NOTIFIED IN CASE OF EMERGENCY)

Next of Kin: Home Address:

Part B: Secondary School Qualification

Year

School

First Name: Date of Birth: / / Tax ID No.: Postal Address: Email Address: Passport Number:

Gender:

Relationship: Phone No.: (Home)

(Work)

Examination Attended

Completed/ Not

Completed

Part C: Tertiary Institution ? (In order of Highest Qualification)

Programme and Institution [Certificate/Diploma/Degree/Post grad / Masters /PhD

Major/ Minor

Duration

Start Date

End Date

Status [Complete / in Progress

Any other Relevant Training Attended Course

Institution

Date

Computer Literacy ? MS Office [ ] Satisfactory [ ] Intermediate

[ ] Good

[ ] Proficient

Part D: Work Experience (List all positions held starting with the present job)

Name of Employer

Position Held

Reasons for leaving

Dates

Start Date Month/Year

End Date

Month/ Year

Part E: Three (3) Referees' (Non Relative)

Name Position & Organization Immediate Phone Contact Email Address Capacity in which referee is known to applicant

Referee 1 (Most Recent)

Referee 2

Referee 3

Part F: Mandatory Feedback

1. Do you have any pre-existing injury or medical condition we should be aware of which could deter you from

performing your job duties?

Yes No

If Yes, please provide explanation/supporting document.

__________________________________________________________________________________________

2. Do you have any disability we should be aware of? Yes No If Yes, please provide explanation/supporting document. __________________________________________________________________________________________

3. Have you been affiliated with Ministry of Economy previously? Yes No If Yes, please elaborate. __________________________________________________________________________________________

4. Do you have any relatives at Ministry of Economy? Yes No If Yes, please elaborate. __________________________________________________________________________________________

5. Do you have any business or secondary employment apart from your primary employment? Yes No If Yes, please elaborate. __________________________________________________________________________________________

Declaration

I certify that information contained in this application is true and complete. I understand that false information may be grounds for not hiring me or for immediate termination of employment at any point in the future if I am hired. I authorize the verification of any or all information listed above.

................................................. Signature of Applicant

....................... Date

Ministry of Economy supports equal employment opportunity and this information will not be discriminatory in any manner.

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