Z83 Form Must be Filled by South African's Applicant

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Application for Employment
A. THE ADVERTISED POST
Position for which you are applying
(as advertised)
Department where the position was
advertised
Reference number (as stated in the
advert)
If you are offered the position,
when can you start OR how much
notice must you serve with your
current employer?
B. PERSONAL INFORMATION
Surname
First Names
Date of Birth
ID number
2
Race
3
African White Coloured Indian
Gender
3
FEMALE MALE
Do you have a disability?
3
YES NO
Are you a South African Citizen? YES NO
If no, what is your
Nationality
And do you have a valid work
Permit?
YES NO
Have you ever been convicted of a
criminal offence or been dismissed
form employment?
4
YES NO
If your profession or occupation
requires State or official
registration, provide date and
particulars of registration.
C. HOW DO WE CONTACT YOU
Preferred language for correspondence?
Telephone number during office hours ( )
Preferred method for
correspondence
Post E-mail Fax
WHAT IS THE PURPOSE OF THIS
FORM
To assist a government department
in selecting a person for an
advertised post.
This form may be used to identify
candidates to be interviewed.
Since all applicants cannot be
interviewed, you need to fill in this
form completely, accurately and
legibly. This will help to process
your application fairly.
WHO SHOULD COMPLETE THIS
FORM
Only persons wishing to apply for
an advertised position in a
government department.
ADDITIONAL INFORMATION
This form requires basic
information. Candidates who are
selected for interviews will be
requested to furnish additional
certified information that may be
required to make a final selection.
SPECIAL NOTES
1 All information will be treated
with the strictest confidentiality
and will not be disclosed or used
for any other purpose than to
assess the suitability of a person,
except in so far as it may be
required and permitted by law.
Your personal details must
correspond with the details in your
ID or passport.
2 Passport number in the case of
non-South Africans.
3 This information is required to
enable the department to comply
with the Employment Equity Act,
1998.
4 This information will only be
taken into account if it directly
relates to the requirements of the
position.
5 Applicants with substantial
qualifications or work experience
must attach a CV.
Correspondence contact
details (in terms of above)
D. LANGUAGE PROFICIENCY state ‘good’, ‘fair’ or ‘poor’
Languages (specified)
Speak
Read
Write
E. QUALIFICATIONS
5
(please ignore if you have attached a CV with these details
Name of School / Technical College Highest qualification obtained Year
Obtained
Tertiary education (complete for each qualification you obtained)
Name of Institution Name of Qualification
Year
Obtained
Current study (institution and qualification)
F. WORK EXPERIENCE
5
(please ignore if you have attached a CV with these details)
From To Employer (including
current employer)
Post held
MM YY MM YY
Reason for
Leaving
If you were previously employed in the Public Service, indicate whether
any condition exists that prevents your re-employment
YES NO
If yes, provide the name of the previous employing
department
G. REFERENCES (please ignore if you have attached a CV with these details)
Name Relationship to you Tel. No. (office hours)
DECLARATION
I declare that all the information provided (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 disqualified or my discharge if I am appointed.
Signature: Date: