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City Power Application Form For Employment

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CITY POWER

APPLICATION FORM FOR


EMPLOYMENT

June 2022
APPLICATION FORM FOR EMPLOYMENT

TERMS AND CONDITIONS

The purpose of this form is to assist City Power in selecting suitable candidates for
an advertised post.
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.
Candidates shortlisted for interviews may be requested to furnish additional
information that will assist City Power to expedite recruitment and selection
processes.
All information received will be treated with strict confidentiality and will not be
used for any other purpose than to assess the suitability of the applicant.
This form is designed to assist City Power with the recruitment, selection
and appointment of senior managers in terms of the Local Government: Municipal
Systems Act, 2000 (Act No. 32 of 2000).
A. DETAILS OF THE ADVERTISED POST (as reflected in the advert)

Advertised post applying for

Reference number

Notice service period None 1 month 2 months Other (specify)

B. PERSONAL DETAILS

Surname

First Names

ID Number/SAP No.

Race African Colored Indian White

Gender Female Male

Do you have a disability? Yes No

If yes, elaborate

Are you a South African citizen? Yes No

C. CONTACT DETAILS

Email address

Telephone Number

2
Mobile Number

Physical Address

Preferred method for Email Telephone Mobile Number Physical


correspondence Address

D. QUALIFICATIONS (Please attach certified qualifications certificate. Additional


information may be provided on your CV)

HIGHEST QUALIFICATION OBTAINED

Name of institution Name of Qualification Qualification Type (e.g., Year Obtained


Diploma, Certificate,
Degree, Honours,
Masters, PhD etc.) and
NQF Level

OTHER QUALIFICATIONS OBTAINED

Name of institution Name of Qualification Qualification Type (e.g., Year Obtained


Diploma, Certificate,
Degree, Honours, Masters,
PhD etc.) and NQF Level

E. WORK EXPERIENCE (Additional information may be provided on your CV)

Employer Position From To Number of

3
(starting with MM YY MM YY Years / Specific reason for
most recent) Months
leaving (this could
(Duration)
include resignation,
dismal,
retrenchment,
retirement or other.
If other, please
specify

Were you previously employed in Local, Provincial and/or National Yes No


Government:

If you were previously employed in Local, Provincial and National Yes No


Government, indicate whether any condition exists that prevents
re-employment:

If yes, provide the name of the previous employing institution:

F. STATUTORY PROFESSIONAL BODY REGISTRATION:

Do you hold a professional membership with any professional body? If yes, provide information
below:
Professional Body Membership Number Expiry date

G. DISCIPLINARY RECORD

4
Have you been dismissed for misconduct Yes No

If yes, Name of Institution:

Type of Misconduct/Transgression

Date of Disciplinary case finalized

Did you resign from your job pending finalization of the Yes No
disciplinary proceedings? This includes notified
investigations, suspensions, charges disciplinary hearing or
other. If yes, provide specific details on a separate sheet.

H. CRIMINAL RECORD

Were you convicted of a criminal offence involving financial Yes No


misconduct, fraud or corruption on or after 5 July 2011? If
yes, provide details on a separate sheet.

If yes, type of criminal act

Date criminal case finalised

Outcome/Judgement

I. REFERENCE

Name of Referee Relationship Tel (office hours) Cellphone Email


Number

J. DECLARATION

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

Signature: Date:

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