CURRO HOLDINGS APPLICATION FOR EMPLOYMENT CURRO HOLDINGS AANSOEK OM INDIENSNEMING Post Applied For / Pos Waarvoor Aansoek Gedoen Word

Reference number (if applicable) Verwysingsnommer (indien van toepassing)

Name of School where position is advertised Skool waar pos geadverteer is

Date of application Datum van aansoek

Full Name Volle Name Surname Van Preferred Name Noemnaam ID / Passport Number ID- / Paspoortnommer Gender Geslag

Male / Manlik

Race Ras

African / Swart 





Female / Vroulik White / Wit 

Asian / Asiër 

Coloured / Kleurling 

Indian / Indiër 

Nationality Nasionaliteit If not a SA Citizen, please provide valid work permit number. Indien nie ’n SA Burger nie, verskaf asseblief ’n werkspermit nommer. Marital Status Huwelikstatus

Expiry date of work permit Vervaldatum van werkspermit

Single / Enkel  Married / Getroud  Divorced / Geskei  Widowed / Wewenaar/Weduwee  Other / Ander  Specify / Spesifiseer

Home Language Huistaal Other Languages Ander Tale Residential Address Woonadres Postal Address Posadres Telephone - Home Telefoon - Huis

Telephone - Work Telefoon - Werk

Telephone - Cell Telefoon - Sel

E-mail Address E-pos Adres

Drivers’ License Code Bestuurderslisensie Kode

Expiry date of Drivers’ License Vervaldatum van bestuurderslisensie

PDP

Yes / Ja



No / Nee



Own Transport Eie Vervoer

Yes / Ja



No / Nee



Disabled Yes / Ja  No / Nee Gestremd Name of a person to contact if you are unavailable. Naam van ’n persoon om te kontak indien u nie beskikbaar is nie. Cell number of person mentioned above. Selnommer van bogemelde persoon.



Are you willing to relocate? Is u gewillig om te verhuis? Are you currently employed? Is u tans in diens? Are you related to, or friends with anyone currently employed by the Curro Group? Is u verwant aan, of vriende met enige persoon wat tans indiens is van die Curro Groep? Relation specified to someone in the Curro Group (Name, position

Expiry date of PDP Vervaldatum van PDP

If yes, please specify. / Indien ja, spesifiseer asseblief.

Yes / Ja



No / Nee



Yes / Ja



No / Nee



and at which School or Department employed)

Verwantskap met persoon wat tans in diens is van die Curro Groep (Naam, posisie en by watter Skool of Departement in diens)

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Current Remuneration Huidige Vergoeding Last pay slip must be submitted if invited for an interview. Laaste betaalstrokie moet ingedien word indien genooi word vir ’n onderhoud. Current Benefits Huidige Voordele

Salary Expectation Salaris Verwagting

Before Deductions Voor Aftrekkings

After Deductions Na Aftrekkings

R Per Month / Per Maand

R Per Month / Per Maand

R Per Month / Per Maand (Must be Completed. / Moet Ingevul Word.)

(Proof of any benefit not indicated on your pay slip must be submitted if invited for an interview.) (Bewys van enige voordele wat nie op u betaalstrokie aangedui word nie, moet ingedien word indien u genooi word vir ’n onderhoud.) Availability 1 Week  2 Weeks / Weke  1 Month / Maand  Beskikbaarheid Other / Ander  Specify / Spesifiseer Please provide two contactable references. (People you reported to.) Verskaf asseblief twee verwysings wie gekontak kan word. (Persone aan wie u gerapporteer het.) NAME & SURNAME NAAM & VAN

COMPANY / SCHOOL MAATSKAPPY / SKOOL

POSITION POSISIE

TELEPHONE NUMBER TELEFOONNOMMER

Criminal record and / or credit checks may be conducted on prospective candidates. Kriminele rekord en / of kredietbeheer mag gedoen word op voornemende kandidate. Have you been convicted of a crime for which a pardon has not been granted? Is u al van ’n misdaad skuldig bevind waarvoor verskoning nie toegestaan is nie?

Yes / Ja



No / Nee



Do you have a negative credit record? (only if applicable to the post) Het u ’n negatiewe kredietrekord? (alleenlik indien van toepassing op die pos)

Yes / Ja



No / Nee



Will you be willing to complete relevant psychometric assessments? YES Sal u bereid wees om relevante psigometriese assesserings te voltooi? JA Are you registered with SACE? If yes, SACE Registration Number

EDUCATION OPVOEDING

 

NO  NEE 

Is u by SACE geregistreer? Indien ja, SACE Registrasienommer

INSTITUTION INSTANSIE

Yes / Ja



No / Nee

COMPLETED QUALIFICATION VOLTOOIDE KWALIFIKASIE



YEAR JAAR

SUBJECTS VAKKE

High School Hoërskool

Tertiary Tersiêre

Other Ander

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EMPLOYMENT HISTORY WERKSGESKIEDENIS DATES OF EMPLOYMENT DATUMS VAN INDIENSNEMING

EMPLOYER WERKGEWER

GRADE, SUBJECTS & OTHER FUNCTIONS GRADE, VAKKE & ANDER FUNKSIES

POSITION POSISIE

REASON FOR LEAVING REDE VIR DIENSVERLATING

EXTRACURRICULAR ACTIVITIES: SPORT, CULTURE, LEADERSHIP AND / OR OTHER EKSTRAKURRIKULÊRE AKTIWITEITE: SPORT, KULTUUR, LEIERSKAP EN / OF ANDER ACTIVITY AKTIWITEIT

TEAM / GROUP SPAN / GROEP

QUALIFICATION RELATED TO ACTIVITY KWALIFIKASIE M.B.T. AKTIWITEIT

I declare that the information supplied by myself is true and correct as on the date of signing this document. I further declare that, should any information I supplied be untrue, be a misrepresentation of the truth, false and/or misleading, my application and possible placement would be null and void. Ek verklaar dat die inligting deur my verskaf waar en korrek is soos op die datum van ondertekening van hierdie dokument. Ek verklaar verder dat, indien enige inligting wat ek verskaf onwaar, ’n wanvoorstelling van die waarheid, vals en/of misleidend is, my aansoek en moontlik plasing nietig sal wees.

_____________________________________________ Signature of Applicant / Handtekening van Aansoeker

________________ Date / Datum

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FOR OFFICE USE • VIR KANTOORGEBRUIK TO BE COMPLETED BY THE SUCCESSFUL CANDIDATE MOET DEUR DIE SUKSESVOLLE KANDIDAAT VOLTOOI WORD EMPLOYMENT INFORMATION INDIENSNEMING INLIGTING

To be completed by an authorised consultant. Moet voltooi word deur ’n gemagtigde konsultant. st

Employment Number Indiensneming Nommer

1 Assignment 1ste Opdrag

Begin Date Begindatum

1 Assignment Duration (Months) 1ste Opdrag Tydperk (Maande)

Rate of Pay Loon

st

Paid Per Betaal Per

R

Month / Maand 

Cost Centre Kostesentrum

Order Number Order Nommer

Branch Tak

Rates Code Tariewe Kode

Job Title Werkstitel

Code Kode

PERSONAL INFORMATION PERSOONLIKE INLIGTING

Week 

OT After OT Na

To be completed by the successful applicant. Moet voltooi word deur die suksesvolle kandidaat.

Surname Van Full Name Volle Name Preferred Name Noemnaam ID Number ID-nommer

Date of Birth Geboortedatum

Postal Address Posadres

Postal Code Poskode

Residential Address Woonadres

Postal Code Poskode

Title Titel

Mr  Miss  Mrs  Ms  Dr  Prof  Other  Specify Mnr  Mej  Mev  Me  Dr  Prof  Ander  Spesifiseer

Race Ras

African / Swart 

Gender Geslag

Male / Manlik



White / Wit 

Asian / Asiër 

Female / Vroulik

Marital Status Huwelikstatus

Telephone Number Telefoonnommer

Other Contact Ander Kontak Yes / Ja



No / Nee



Indian / Indiër 



Home Language Huistaal

Driver’s License Bestuurderslisensie

Coloured / Kleurling 

Code Kode

Tax Number Belastingnommer Serious Illness / Disabilities Ernstige Siektes / Gestremdheid BANKING DETAILS BANKBESONDERHEDE

Your salary will be paid directly into your bank account. This is mandatory. U salaris sal direk in u bankrekening betaal word. Hierdie is verpligtend.

Account Owner / Name Rekening Eienaar / Naam

Bank Name Banknaam

Branch Name and / or Code Taknaam en / of Kode

Account Number Rekeningnommer

Account Type Rekening Tipe

Current  Lopend 

Cheque  Savings  Transmission  Tjek  Spaar  Transmissie 

NEXT OF KIN NAASBESTAANDES

In case of an emergency, who can we contact? In ’n noodgeval, wie kan ons kontak?

st

Telephone Number Telefoonnommer

nd

Telephone Number Telefoonnommer

1 Nominee 1ste Genomineerde 2 Nominee 2de Genomineerde

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FOR OFFICE USE VIR KANTOORGEBRUIK

For our Records Vir ons Rekords

Credit Check Kredietbeheer

Yes / Ja



No / Nee



Outcome Uitkoms

Criminal Record Check Kriminele Rekord Beheer

Yes / Ja



No / Nee



Outcome Uitkoms

Reference Check Verwysingsbeheer

Yes / Ja



No / Nee



Outcome Uitkoms

I hereby declare that the above information is true and correct to the best of my knowledge and hereby agree that, should the above information be incorrect, I will not in any way hold Omega HR Solutions responsible. Hiermee verklaar ek dat die bogenoemde inligting waar en korrek is na die beste van my kennis en stem ek hiermee saam dat, indien die bogenoemde inligting nie korrek is nie, ek Omega HR Solutions nie op enige manier verantwoordelik sal hou nie.

_____________________________________________ Signature / Handtekening

________________ Date / Datum

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