STAFF VACANCIES

HR201
APPLICATION FORM
All applicants are required to submit the following information:

 Covering letter of application.

 Application form (see below).
 Full curriculum vitae (only copies of requested documents to be included).
 Any other relevant information specified in the advertisement.

UCT Job applicant privacy statement

When you apply for a position at UCT we either collect this information directly from you or from recruiters who help us find suitable
candidates. We use your personal information to review your application, correspond with you and arrange travel and
accommodation for interviews. We use the information about your race, gender, disability and nationality to implement our
employment equity plan under the Employment Equity Act. We may need to use third parties to help us verify some of the
information you shared with us by contacting the references you provided and confirming your qualifications. For some roles, we
may do criminal and credit checks. For more information about how the University of Cape Town uses personal information and your
rights, visit our Privacy Notice.

An application which does not comply with the above requirements will be regarded as incomplete.
Post applied for usher Ref. No. E24501
Department /Faculty Baxter theatre

Title miss Initials z.o

Please enter your first and last names below as they appear in your identification document or passport.
First Name/s zarah Surname oostendorp

Residential 65 aries road , surrey estate athlone

address Postal code
Email address Zarahoostendorp17@gmail.com
Work number 0747085001 Home number
Mobile number 0747085001
Date of Birth 7 november 2005 Gender female
ID or passport number
Nationality South african (please attached a copy of 0511070546086
your ID)
Driver’s licence Yes No If yes, licence code
EMPLOYMENT EQUITY INFORMATION (This information is required to inform the University towards the implementation of its
employment equity plan in accordance with the Employment Equity Act, Act 55 of 1998)
Note: Disability declaration: Employment Equity legislation defines people with disabilities as people who have a long-term
or recurring physical, mental, intellectual or sensory impairment which, in the interaction with various barriers, may substantially limit
their prospects of entry into, or advancement in employment.
Race African Coloured Indian White Foreign National
If none of the above, please provide details
If you are not a RSA citizen by birth or
Are you a RSA citizen? Yes No naturalized before 27 April 1994, please
indicate the date you acquired your citizenship
In possession of a Work Permit? (If yes, please
If invited for interview, would you require a
provide a copy of your current permit with your Yes No Yes No
visa?
application)
Does your disability require special interview
Do you have a disability? Yes no Yes No
arrangements?
If yes, please indicate the nature of your disability

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 Have you ever worked at UCT?

Yes No If yes, dates of employment?

If yes above, previous department?

Notice Period

Where did you see this vacancy advertised for the first time?
(Please indicate name of media or website)
Baxter theater website4

Are you currently registered with a recruitment agency? Yes No

If yes, please specify agency name

Three referee names and contact details

(These referees may be contacted directly by UCT at any stage of the selection process)
Title and Name Position and Company/Institution Relationship to you Contact details (email address & tel no)

Summary of Qualifications, Registration with Professional bodies and Experience

Note: Please enter your qualifications and employment history information in this section as well as on your CV.
Qualifications (All qualifications are verified prior to appointment)
Please indicate the NQF level of your highest qualification
4
(please attached a copy of your highest qualification)
School certificate/Degree/Diploma/Other qualification obtained Institution Year

Registration with Professional bodies (Please list the most recent first)
Professional registration type / level Registration number Name of registration body

Employment History (Please list the most recent first)

Please indicate your total years of experience that is relevant to the position you are applying for.
<1 year 1–2 2 -3 3-4 4-5 5-6 6-7 7–8 8–9 9 – 10 >10 years
Position Company/Institution Dates of employment
Brand promoter smollan 15th February 2024
Voluntary teachers assistant Rondebosch east primary 15th april 2024

FOR ACADEMIC POSTS ONLY: In addition to the above, please complete the following information
If the post is advertised across levels (e.g. Professor / Associate Professor / Senior Lecturer /
Lecturer), please specify the level/s at which you are applying
If the post is advertised across levels (e.g. Professor / Associate Professor / Senior Lecturer /
Lecturer) and you are not successful at the level for which you applied, would you like to be Yes No
considered at a lower level?

Main research areas of interest

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Research output
Number of publications in peer-reviewed journals
Number of publications in conference proceedings
Other (including papers accepted, but yet to appear)

Books
Number of monographs Number of edited collections
Number of book chapters
Other (including forthcoming publications, book reviews,
non-peer-reviewed exhibition catalogues)

Supervision of students
Number of Honours students graduated
Number of Masters students graduated
Number of Doctoral students graduated

Teaching Experience (List courses taught and the size of classes)

Declarations (To be completed by all applicants)

Are there any circumstances relevant to your application of which, in the interests of fair and frank Yes  No
disclosure, you should make the selection committee aware? (if so, salient particulars are required) Attach separate page if necessary

Are you facing, have you faced, or do you envisage having to face any disciplinary (professional or Yes  No
criminal charges)? (if so, salient particulars are required) Attach separate page if necessary

Have you been found guilty of professional misconduct or a crime? (if so, salient particulars are Yes  No
required)
Attach separate page if necessary

Note: The above information will be treated in the strictest confidence. Criminal checks (via a fingerprint process) are conducted
for all successful candidates, with their prior permission.

I declare that all the information provided is complete and correct

Name Zarah oostendorp Date 16/05/2024

Signature

21 September 2022 Page 3 of 3 HR201