Joburg Market (SOC) Ltd
Heidelberg Road PO Box 86007 Tel +27(0) 11 992 8000
City Deep City Deep, Fax +27(0) 11 613 7381
Johannesburg Johannesburg E-mail: info@[Link]
2049 South Africa
2049
APPLICATION FORM FOR EMPLOYMENT
TERMS AND CONDITIONS
1. The purpose of this form is to assist Joburg Market in selecting suitable candidates for an advertised post.
2. This form must be completed in full, accurately and legibly. All substantial information relevant to a candidate
must be provided in this form. Any additional information may be provided on the CV.
3. Candidates shortlisted for interviews may be requested to furnish additional information that will assist Joburg
Market to expedite recruitment and selection processes.
4. All information received will be treated with strict confidentiality and will not be used for any other purpose
than to assess the suitability of the applicant.
5. This form is designed to assist Joburg Market with the recruitment, selection and appointment of senior
managers in terms of the Local Government: Municipal Systems Act, 2000 (Act No. 32 of 2000).
A. DETAILS OF THE ADVERTISED POST (as reflected in the advert)
Advertised post applying for
Reference number
Notice service period
B. PERSONAL DETAILS (* required for employment equity reporting)
Surname
First Names
ID or Passport Number
*Race (Mark with an X) African Coloured Indian White
*Gender (Mark with an X) Female Male
*Do you have a disability? (Mark Yes No
with an X)
If yes, elaborate
Are you a South African citizen? Yes No
If no, what is your nationality?
Work Permit Number (if any):
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Do you hold a professional membership with any professional body? If yes, provide (Mark Yes No
with an X)
Professional Body: Membership Number: Expiry date:
C. CONTACT DETAILS
Preferred language for
Correspondence?
Telephone number
during office hours
Preferred method for
correspondence Post E-mail Fax
(Mark with an X)
Correspondence contact
details (in terms of above)
D. QUALIFICATIONS (Additional information may be provided on your CV)
Name of School / Technical
College
Name of Institution
E. WORK EXPERIENCE (Additional information may be provided on your CV)
Employer (starting with From To
most recent) Position MM YY MM YY Reason for leaving
If you were previously employed in Local Government / Public
Service, indicate whether any condition exists that prevents your Yes No
re-employment: (mark with an x)
If yes, provide the name of
the previous employing
municipality / municipal entity
F. DISCIPLINARY RECORD
Have you been dismissed for misconduct? Yes No
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If yes, Name of Municipality/ Municipal Entity:
Type of a Misconduct/ Transgression
Date of Resignation/ Disciplinary case finalised
Award/sanction
Did you resign from your job pending
finalisation of the disciplinary proceedings? If yes, provide details Yes No
on a separate sheet. (mark with an x)
G. CRIMINAL RECORD
Were you convicted of a criminal offence involving financial
misconduct, fraud or corruption? If yes, Yes No
provide details on a separate sheet. (mark with an x)
If yes, type of criminal act
Date criminal case finalised
Outcome/ Judgment
H. REFERENCE
Name of Referee Relationship Tel(office hours) Cellphone number Email
I. DECLARATION
I hereby declare that all the information provided in this application and any attachments in support thereof is to the
best of my knowledge true and correct. I understand that any misrepresentation or failure to disclose any information
may lead to my disqualification or termination of my employment contract, if appointed.
Signature: Date:
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