Regulations > Regulations for the Staff of the Human Rights Commission, 1996 > Schedules > Schedule A : Forms

FORM 1

APPLICATION FOR APPOINTMENT

[Regulation 4(1)]

Note:

This form is to be completed in ink in your own handwriting and in block letters. The following documentation shall accompany the application form:

(a) Certified copy of your identity document.

(b) Health questionnaire.

(d) Service certificates, or, if not available, an affidavit by you, regarding your previous periods of service.

(e) Testimonials by previous employers.

(f) Affidavit of assets and liabilities.

A.	OFFICE DESIRED

1.	Office desired

............................................................................................................................

2.	When can you accept service? .............................................................................

B.	ADVERTISING PARTICULARS

1.	Reference number (if any)

............................................................................................................................

C.	PERSONAL PARTICULARS

1.	Surname (also maiden name if applicable)

............................................................................................................................

2.	First names

............................................................................................................................

3.	Permanent postal address

............................................................................................................................

..........................................................................Code .........................................

4.	Telephone numbers

(H)	................................................................................................................

(W)	.................................................................................................................

5.	Indicate with an X:

(i)	Male …....…… (v) Divorced ……...….

(ii)	Female ………. (vi) Widower …..…….

(iii)

Married ………. (vii) Widow ……….......

(iv)	Unmarried ……….

6.	Number and age of dependent children ..............................................................

7.	Date of birth ........................................................................................................

8.	Identity number ..................................................................................................

9.	Are you a South African citizen? If not, give nationality .......................................

............................................................................................................................

10.

Indicate:

(i)	Have you ever been found guilty of a criminal offence? ..........................

(ii)	Have you ever paid an admission of guilt fine with regard to any offence?

...............................................................................................................

(iii)

Have you ever appeared in a court as an accused? ..................................

(iv)	Have you ever received a postponed fine? .............................................

(v)	Was the imposition of sentence ever postponed in your case?

...............................................................................................................

(vi)	Have you ever been imposed a suspended sentence? ............................

If you have answered positively to any of the questions in paragraph 10, attach hereto full particulars thereof.

11.	Official language in which you prefer to receive your correspondence

D.	LANGUAGE PROFICIENCY

State "good", "fair", "bad"

	Languages (Please specify)

Speak ...................
Read.....................
Write ....................

E.	QUALIFICATIONS

Name of educational institution and centre	Certificates, diplomas and degrees obtained	ALL SUBJECTS: (underline major subjects. In the case of typewriting and shorthand, state language and speed)	Month, year and place obtained	Normal duration of course	How was the highest qualification obtained? Indicate with an X in the appropriate spaces
School/Technical College	Name only highest qualification				Mainly full-time study
					Mainly part-time study
					Mainly own expense
University and other courses	Mention all qualifications				Mainly state expense
State field of further study (if any)

F.	EXPERIENCE

		From			To
Employer (also present)	Position held	Y	M	D	Y	M	D	Reason for leaving

I declare that the above-mentioned particulars are complete and correct and understand that if I give any false information, I am guilty of misconduct.

…………………………………………………….. …………………………………………..

Signature Date

South African Human Rights Commission Act, 2013 (Act No. 40 of 2013)

Regulations

Regulations for the Staff of the Human Rights Commission, 1996

Schedules

Schedule A : Forms

Form 1 : Application for Appointment