CROWN CHRISTIAN SCHOOL EMPLOYMENT PROFILE FORM 1. INSTRUCTIONS (a) This form combines the application form CCS November 2014 and the CV into one EMPLOYMENT PROFILE FORM. This is the only form that will be recognised when applying for vacant posts advertised. (b) A separate application form must be submitted in respect of every post applied for. (c) Every application must be accompanied by certified copies of educational qualifications, certified ID and SACE. (d) All applications must be submitted as indicated in the advertisement in accordance with the instructions appearing in the vacancy list. (e) It is compulsory that all sections of the form be completed as honestly as possible where applicable. (f) Please PRINT. Mark blocks with an X where applicable. (g) Only original signatures (no photocopies of signatures) will be valid on this form. Faxed or e-mail copies of this document will be accepted. (h) Post number MUST be in correct format e.g. CCSOO5P (NO EXCEPTION WILL BE ALLOWED) 2. PARTICULARS OF ADVERTISED POST Name of School (as advertised in vacancy list) Post Description (as stated in the advert e.g. Educator) Post Number (as stated in the advert) (ONE digit per block please) (e.g.) CCSFPH001) Post Level NOVEMBER 2014 (please refer to the List of Vacancies [as advertised] for instructions to complete this form) CCS EMPLOYMENT FORM 2 3. PERSONAL PARTICULARS OF APPLICANT SURNAME & INITIALS S NAME(S) H I O N R T T E L R I V S I T E I W PERSAL NO (if currently/previously employed) I.D. NO (attach copy of ID doc with an original stamp of certification) GENDER (male/female) Male RACIAL GROUP (for Employment Equity Purposes) African Female Coloured Indian White Are you professionally registered (PLEASE STATE BODY AND NUMBER) (e.g. SACE/HPCSA) Do you have a disability? (Yes or No) if yes, indicate Nature Yes No Are you a South African Citizen Yes No If NO, what is your nationality Do you have a valid work permit? (Foreigners Only) Yes/No Yes No If YES, permit no (foreigners only) Have you been convicted of a Yes criminal offence (if yes, attach details on a separate sheet) No Have you been charged with misconduct (if yes, attach details on a separate sheet) Yes No Are you currently employed? Yes No Have you been employed in the Yes No If yes, how was your service terminated? Please indicate date VSP (voluntary RESIGNED N ILL HEALTH severance package) G MISCONCUCT Other (specify) 4. CONTACT DETAILS Telephone numbers during office hours Telephone numbers after office Fax number Cell number Email Address 5. LANGUAGE PROFICIENCY—STATE ‘GOOD’, ‘FAIR’ OR ‘POOR’ LANGUAGES (specify) Speak CCS EMPLOYMENT FORM 3 Write Read 6. QUALIFICATIONS (ATTACH SEPARATE SHEET IF NECESSARY) School/University/ college Qualification (s) Subjects Date Obtained Attach certified copies of all qualifications and subject statement (in case of PL 1-3) 7. PROFESSIONAL QUALIFICATIONS (i.e. Secondary Teachers Diploma) Institution Qualification (s) Subjects (specify major Date Obtained Attach certified copies of all qualifications and subject statement 8. ADDITIONAL QUALIFICAIONS / COURSES ATTENDED (e.g. OBE Course) Name of Course Service Provider Duration of course 1. 2. 3. 4. 5. 9. EXPERIENCE (a) CURRENT EMPLOYMENT Department/Employer Institution Post Level Earning Areas & Grades EXACT DATES From TOTAL To Years Month CCS EMPLOYMENT FORM 4 (b) PREVIOUS EMPLOYMENT IN EDUCATION Department/Employer Institution Post Level Earning Areas & Grades EXACT DATES From TOTAL To Years Month 10. EXTRA AND CO-CURRICULAR ACTIVITIES (Other capabilities, e.g. projects) TYPE OF ACTIVITY ORGANISATION DURATION 1. 2. 3. 11. NON-TEACHING/COMMUNITY EXPERIENCE (e.g. church, social affairs, etc.) ORGANISATION POSITION HELD TYPE OF ACTIVITY 1. 2. 3. 12. SKILLS (e.g. communication, computer, etc.) 1. 2. 3. 13. PERSONAL QUALITY TRAITS (i.e. your strengths) 1. 2. 3. DURATION CCS EMPLOYMENT FORM 5 14. OTHER RELEVANT INFORMATION 1. 2. 3. 15. REFERENCES (Preferably Professional reference) NAME CONTACT DETAILS RELATIONSHIP 1. 2. 3. 16. DECLARATION I declare that the above information provide (including any attachments) is true and correct to the best of my knowledge. I understand that any false or incorrect information could lead to my application being disqualified or to me be discharge on account of misconduct if appointed. Failure to disclose will result in disqualification. _____________________________________ SIGNATURE OF APPLICANT __________________________ DATE Please Note: Only original signature will be regarded as valid (photocopied signatures will not be acceptable)