REGISTRATION ON EDUCATORS UNEMPLOYMENT DATABASE
Reg Form No:…………….
(For office use)
REGISTRATION FORM: FURTHER EDUCATION AND TRAINING COLLEGES LECTURER DATABASE
INVITED TO REGISTER: Retired lecturers, unemployed lecturers, lecturers currently applying their trade in Industry and foreign based lecturers.
|PERSONAL DETAILS |
|Surname: | |Initials: | |Passport No: | |
|Full Names: | |Gender: | |Nationality: | |
|Identity Number: | |Main Language: | |
|CONTACT DETAILS |
|Postal Address: |Home Address (not a post box number): |
| | |
| | |
| | |
| | |
| | | | |
|Postal Code: | |Postal Code: | |
|Tel No (Home): | |Cell No: | |
|Tel No (Work): | |E-mail: | |
|EDUCATIONAL BACKGROUND |
|Highest Academic Qualification |
|Type of qualification: (please tick (x) where relevant) |Degree |Diploma |Certificate |
|Name of qualification: | |
|Institution where the qualification was obtained: | |Year obtained: | |
|Major subjects |1. |2. |3. |
|Highest Teaching Qualification |
|Name of the Qualification: | |Year obtained: | |
|Institution where the qualification was obtained: | |
|Major subjects | | |3. |
|Professional Registration |
|Name of the Association | |
|Registration number | |Date registered | |
|WORK EXPERIENCE (start with most recent) |
|Name of the Employer |Post held |Date From |Date To |
|1. | | | |
|2. | | | |
|3. | | | |
|4. | | | |
|For ONLY teaching experience |
|Name of Employer |Subjects Taught |Level trained/taught |No of Yrs |
| | |(Grade/NCV/Nated/Tertiary) | |
|1. | | | | |
|2. | | | | |
|3. | | | | |
|4. | | | | |
|REFERENCES |
|Name: |Relationship: |Tel Number: |
|1. | | | |
|2. | | | |
|3. | | | |
I declare that all the information provided is complete and correct. I understand that any false information supplied could lead to my application being disqualified or my discharge if I am appointed. Please complete, sign and submit the form to the Directorate: Education Labour Relations and Conditions of Service; Room 625; 123 Francis Baard Street; Pretoria; 0001 or fax to email: 086 298 9996 attention to Mr MD Phaka.
Signature…………………….. Date: ………/………/………
Day Month Year
SHORT RESUME:
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