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New Application Form For Employment MSR - 2022

This document is an application form for employment designed to assist municipalities in selecting suitable candidates. It requires candidates to provide personal details, qualifications, work experience, and declarations regarding their disciplinary and criminal records. All information submitted will be treated confidentially and is intended solely for the recruitment process in accordance with the Municipal Systems Act, 2000.

Uploaded by

Rasifudi Mulalo
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© © All Rights Reserved
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49 views3 pages

New Application Form For Employment MSR - 2022

This document is an application form for employment designed to assist municipalities in selecting suitable candidates. It requires candidates to provide personal details, qualifications, work experience, and declarations regarding their disciplinary and criminal records. All information submitted will be treated confidentially and is intended solely for the recruitment process in accordance with the Municipal Systems Act, 2000.

Uploaded by

Rasifudi Mulalo
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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APPLICATION FORM FOR EMPLOYMENT

1. The purpose of this form is to assist a municipality in selecting suitable candidates for a post.

2. This form must be completed in full, accurately, and legibly. All substantial information relevant to a candidate must be provided in this form.
Any additional information may be provided on the CV.

3. Candidates shortlisted for interviews may be requested to furnish additional information that will assist municipalities to expedite recruitment
and selection processes.

4. All information received shall be treated with strict confidentially and shall not be used for any other purpose than to access the suitability of
the applicant.

5. This form is designed to assist a municipality with the recruitment, selection, and appointment of staff members in terms of Municipal
Systems Act, 2000 (Act no. 32 of 2000)

DETAILS OF THE ADVERTISED POST (as reflected in the advert)

Advertised post applying for

Reference number

Name of municipality

Notice serving period

PERSONAL DETAILS

Surname

First names

ID or passport number

Gender Male Female

Race African White Colored Indian

Do you have a disability? Yes No If yes, elaborate

If not, what is your nationality?


Are you a South African citizen? Yes No Do you have a valid
Yes No
work permit?

Do you hold a professional


Membership
membership with any professional Yes No Name of professional body Expiry date
number
body?

1
CONTACT DETAILS

Telephone number during office hours ( )

Mobile phone number

Postal address

Code

Email address

Preferred language of communication

QUALIFICATIONS (please elaborate on CV)

Highest educational qualification obtained

Name of school Highest grade passed Year

Highest tertiary qualification obtained

Name of institution Name of qualification NQF level Year obtained

Work experience (please elaborate on CV)

Contact
Name of
Reason for details of
Employer Post held From To reporting
leaving reporting
supervisor
supervisor
(Starting with

most recent) Month Year Month Year

2
DISCIPLINARY RECORD

Have you been dismissed for misconduct during the past ten (10) Yes No
years?

If yes, name of municipality/employer

Type of misconduct/Transgression

Date of resignation/Disciplinary case finalised/Dismissal

Award/Sanction

Have you been accused of an alleged misconduct and resigned Yes No


from your job pending finalisation of the disciplinary procedure?

CRIMINAL RECORD

Have you been convicted of any criminal offence in court or law Yes No
during the past ten (10) years?

If yes, type of criminal act

Date criminal case finalised

Outcome/ Judgement

REFERENCES (pleas elaborate on CV)

Name of referee Relationship Tel (office hours) Cellphone number Email address

DECLARATION

I_____________________________________________ hereby declare that all information provided in this application or any attachments
in support hereof is to the best of my acknowledge true and accurate. I understand that any misrepresentation or failure to disclose any
information may lead to my disqualification of termination of my employment contract, if appointed.

I herewith consent to undergo screening, vetting and medical testing if required.

Signature: Date:

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