Application Form

For office use only:
PP No
Date Industry
Consultant Job Title
Docs scanned CV - Export References
CONFIDENTIAL PROFILING / APPLICATION FORM

Preferred Name:
Surname:
Full Name: ID Number:
Postal address:
Code:
Home address:
Code:
Marital status: Single Married Divorced Widowed Separated
What is your Race? White Black Colored Asian Indian
Are you a South African citizen? Yes No Other:
Do you have a Disability? Yes No Nature:
Do you have a car? Yes No
Gender? Male Female
Do you have a driver’s license? Yes No Code:
Have you been fully Vaccinated? Yes No
Which Vaccination have you had? Pfizer Johnson & Johnson
Can you Provide your Vaccination
Yes No
Certificate to your Consultant
Telephone number: (work): (home): (cell phone):
E-mail (work): E-mail (personal):
Next of kin Name: Contact No:

Next of kin Occupation: Company:
Would you like to relocate? Yes No or work overseas? Yes No
Home Language: Other Language:
The areas you prefer to work in (Boksburg, Pretoria West, Durbanville)?
Permission to do a credit check when needed: Yes No
The consultants has the right disclose the credit and criminal check to potential employers: Yes No
Do you have any judgments against you? Yes No
Are you aware of any current or previous criminal charges pending against you? Yes No
Do you have any medical or psychological condition? Yes No
Are you on any chronic medication (including anti-depressants)? Yes No
School: Year completed: Grade completed:
Subjects:
University / Colleges / Training institution:
Qualification:
Year completed:
Computer Packages:
Please tick your answer below, to assist us in identifying your requirements:
How serious are you on finding another position?
I HAVE TO FIND A JOB NOW 1 2 3 4 5 BROWSING THE MARKET FOR OTHER OPPORTUNITY
Have you ever accepted a counter offer previously? Yes No

What motivates this move for you?
MONEY 1 2 3 4 5 CAREER
REFERENCES: With whom may we do references straight away?

WORK REFERENCES: List 3 individuals who you reported to during your career
NAME COMPANY POSITION CONTACT NUMBER
COLLEAGUE REFERENCES: List 3 x colleagues in your Industry that you have worked with who are able to give us
a character reference
NAME COMPANY POSITION CONTACT NUMBER
CURRENT REMUNERATION:
Salary Cost to Company package earning now/last:
Salary Cost to Company package required (minimum) per month:
Are you seeking? Permanent Temporary Contract
Current Notice Period? 24hrs 2 weeks 30days 1 calendar month
How is your current package structured?
Basic salary per annum or month:
BENEFITS
Medical Pension
Car allowance Petrol / Travel allowance
Cell phone 13th cheque / Bonus
Other? When is your next increase?
With which Personnel Agencies did you register recently?

Which companies have you been for interviews in the last six months?
Which agencies have you been for interviews in the last six months?
How did you hear about us?
What tools do you use to job hunt (example: Online – Bestjob/PNet)?
Cancellation of Interviews with our Clients

We feel it important to stress the fact that we regard the relationship with our clients as very sensitive, and have experienced the embarrassing
situation of candidates not arriving for interviews without notice on numerous occasions.It thus goes without saying that such a situation can damage
our Company reputation and the relationship with our Client. We are thus requesting a 24 hour notification of cancellation to either the relevant
consultant or contact person with our Client, telephonically. E-mailed cancellations will not be accepted.
By signing this application form:
I hereby confirm and declare that any and all information provided to Dante Personnel Recruitment is true and correct and that I have not altered
and/or amended any documentation that can lead to a criminal and/or fraudulent offence. I therefore understand that the supplying of incorrect,
altered and/or fraudulent documentation may lead to Dante Personnel opening a criminal case against me.
I further understand and consent that any and all information which may be of a discriminatory nature, may be deleted and will not be used by Dante
Personnel Recruitment. I hereby absolve and indemnify Dante Personnel Recruitment of any liability and/or responsibility which may emerge from
the submission of my Curriculum Vitae to Dante Personnel Recruitment to a third party and/or any other forum.
I further declare that all the information and documentation provided by myself is of a valid nature, correct and to the best of my knowledge not
tampered with. I therefore consent that this documentation and information may be utilized for the purposes of placing me in a possible vacancy in
the event of one arising.
I herewith consent that my information be used to present my profile to potential employers and therefore afford Dante Personnel Recruitment the
necessary consent as contained in the POPI Act. It is therefore agreed that Dante Personnel Recruitment will be indemnified against any claim
whatsoever which may arise as a result of a POPI Act infringement.
Signature: Date:

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Application Form

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For office use only:

Docs scanned CV - Export References

CONFIDENTIAL PROFILING / APPLICATION FORM

Next of kin Name: Contact No:

Have you ever accepted a counter offer previously? Yes No

REFERENCES: With whom may we do references straight away?

With which Personnel Agencies did you register recently?

Cancellation of Interviews with our Clients

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