By completing this application form, you hereby:

Consent to the processing of your personal information contained in your CV in terms of Section
11(1)(a) of the Protection of Personal Information Act of 2013, as amended.

- You acknowledge that we have no control over what personal information you insert in your CV
and accordingly you consent to the processing of all such personal information contain therein “as is”,
subject to the provisions of the Protection of Personal Information Act of 2013 and our Privacy Policy

- You consent and acknowledge that Our Human Resources department will have access to your
personal information and will process same only to the extent strictly necessary for recruitment
purposes to fill the vacancy as advertised and all matters ancillary thereto.

- Should you be shortlisted as a candidate, you hereby expressly provide your consent for us to
process and share your personal information for purposes of background checks, which may include
external criminal, credit and reference checks done by third-party service providers.

- Unless shortlisted as a candidate, we will not store or process your personal information any
further and shall remove any personal information that we are in possession.

- If you are shortlisted, but ultimately unsuccessful, we will keep your CV on file for a period of 12
month’s whereafter it will be deleted, unless requested to delete sooner.

I, __ _______________________, hereby consent to the above.

Signed at: ________________ this ________ of ___ 2022.

Full Name and Surname (Mr, Miss)

Known As
Gender

Contact number

Alternative contact no. (office, home,

other)

Email address

Race (client reporting info)

Disability (client reporting info)

Location (Where are you currently
residing)
Nationality

ID Number or Passport (attach)

Date of Birth
Work permit No. and expiry date (please
attach in reply email)
Do you have your own transport?

Driver’s License

Marital Status

Dependants

Notice period

Date available from/contract expiring date

Position Applied For

Contract, Perm or Both

Years Of Experience in role

Any Credit /ITC/Debt records

Any Criminal Records

Latest Degree, Diploma (Please attach a
copy)
Current Gross (monthly) / rate per hour
(attach last 3 payslips)
Current Net Salary (monthly)

Bonus or incentive, benefits, leave

Expected Gross Salary (monthly) / rate per
hour
Expected Net Salary (Monthly)

Contactable Reference.1 Name

Contact No.

Company

Designation

Contactable Reference.2 Name

Contact No.

Company

Designation

DECLARATION

I hereby declare that all information (Including any attachments) is complete and correct to the best of
my knowledge. I understand that any false information supplied could lead to my application being
rejected or my termination of employment if appointed.

Applicant Signature: __ _________________

Application Date: ___ _______________

Documents to accompany application form

1. ID Document
2. Qualifications
3. Last Pay slip