Statistics Act, 1999
R 385
South African Human Rights Commission Act, 2013 (Act No. 40 of 2013)RegulationsRegulations for the Staff of the Human Rights Commission, 1996SchedulesSchedule A : FormsForm 1 : Application for Appointment |
FORM 1
APPLICATION FOR APPOINTMENT
[Regulation 4(1)]
| Note: | This form is to be completed in ink in your own handwriting and in block letters. The following documentation shall accompany the application form: |
(a) Certified copy of your identity document.
(b) Health questionnaire.
(c) Certified copies of all educational qualifications.
(d) Service certificates, or, if not available, an affidavit by you, regarding your previous periods of service.
(e) Testimonials by previous employers.
(f) Affidavit of assets and liabilities.
| A. | OFFICE DESIRED |
| 1. | Office desired |
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| 2. | When can you accept service? ............................................................................. |
| B. | ADVERTISING PARTICULARS |
| 1. | Reference number (if any) |
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| C. | PERSONAL PARTICULARS |
| 1. | Surname (also maiden name if applicable) |
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| 2. | First names |
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| 3. | Permanent postal address |
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..........................................................................Code .........................................
| 4. | Telephone numbers |
| (H) | ................................................................................................................ |
| (W) | ................................................................................................................. |
| 5. | Indicate with an X: |
| (i) | Male …....…… (v) Divorced ……...…. |
| (ii) | Female ………. (vi) Widower …..……. |
| (iii) | Married ………. (vii) Widow ………....... |
| (iv) | Unmarried ………. |
| 6. | Number and age of dependent children .............................................................. |
| 7. | Date of birth ........................................................................................................ |
| 8. | Identity number .................................................................................................. |
| 9. | Are you a South African citizen? If not, give nationality ....................................... |
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| 10. | Indicate: |
| (i) | Have you ever been found guilty of a criminal offence? .......................... |
| (ii) | Have you ever paid an admission of guilt fine with regard to any offence? |
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| (iii) | Have you ever appeared in a court as an accused? .................................. |
| (iv) | Have you ever received a postponed fine? ............................................. |
| (v) | Was the imposition of sentence ever postponed in your case? |
...............................................................................................................
| (vi) | Have you ever been imposed a suspended sentence? ............................ |
If you have answered positively to any of the questions in paragraph 10, attach hereto full particulars thereof.
| 11. | Official language in which you prefer to receive your correspondence |
| D. | LANGUAGE PROFICIENCY |
State "good", "fair", "bad"
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Languages (Please specify) |
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Speak ................... |
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Read..................... |
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Write .................... |
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| E. | QUALIFICATIONS |
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Name of educational institution and centre |
Certificates, diplomas and degrees obtained |
ALL SUBJECTS: (underline major subjects. In the case of typewriting and shorthand, state language and speed) |
Month, year and place obtained |
Normal duration of course |
How was the highest qualification obtained? Indicate with an X in the appropriate spaces |
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School/Technical College |
Name only highest qualification |
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Mainly full-time study |
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Mainly part-time study |
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Mainly own expense |
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University and other courses |
Mention all qualifications |
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Mainly state expense |
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State field of further study (if any) |
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| F. | EXPERIENCE |
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From |
To |
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Employer (also present)
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Position held |
Y |
M |
D |
Y |
M |
D |
Reason for leaving |
I declare that the above-mentioned particulars are complete and correct and understand that if I give any false information, I am guilty of misconduct.
…………………………………………………….. …………………………………………..
Signature Date
