APPLICATION FORM – SOUTH AFRICA
Dear Candidate,
In order for us at FemMinIT to best assist you in finding the position and company you seek, we require accurate
information which will be sent to the client. It is therefore in your best interest to complete the form in as much detail and
send back to your consultant as soon as possible.
SURNAME
FIRST NAMES
PREFERRED NAME
GENDER
ID NUMBER / PASSPORT NUMBER
ARE YOU A SOUTH AFRICAN CITIZEN?
NON SA CITIZENS: DO YOU HAVE A WORK PERMIT?
EMPLOYMENT EQUITY STATUS – PLEASE INDICATE
ASIAN / COLOURED / BLACK / INDIAN / WHITE
SMOKER / NON SMOKER:
CRIMINAL RECORD (TO YOUR KNOWLEDGE)
ITC RECORD (TO YOUR KNOWLEDGE)
CELL PHONE NUMBER
CONTACT DETAILS - NEXT OF KIN
PLEASE STATE RELATIONSHIP
ALTERNATE CONTACT NUMBER
EMAIL ADDRESS (WORK)
EMAIL ADDRESS (PERSONAL)
PHYSICAL ADDRESS (PLEASE INCLUDE PROVINCE YOU
RESIDE IN)
TRANSPORT (OWN, LIFT CLUB, PUBLIC, ETC.)
VALID DRIVER’S LICENSE
DO YOU PREFER PERMANENT OR CONTRACT
OPPORTUNITIES?
GEOGRAPHICAL AREAS YOU PREFER TO WORK IN:
NOTICE PERIOD
PREFERABLE INTERVIEWING TIMES:
MARITAL STATUS
Phone: 011 029 0909 - Mobile: 078 801 8689 - Fax: 086 625 5195 - Email: [email protected]
Website: www.femminit.co.za
NUMBER OF DEPENDENTS
REASON FOR SEEKING ALTERNATE EMPLOYMENT:
SALARY DETAILS
CURRENT COST TO COMPANY
(BASIC SALARY + ALL BENEFITS)
AMOUNT YOU RECEIVE BEFORE DEDUCTIONS
CURRENT NETT SALARY:
(AMOUNT RECEIVED AFTER DEDUCTIONS)
EXPECTED COST TO COMPANY
EXPECTED NETT SALARY:
ADDITIONAL SALARY INFORMATION
YES/NO
FREQUENCY/WHEN/AMOUNTS?
DO YOU RECEIVE A GUARANTEED / NON-GUARANTEED BONUS / 13TH CHEQUE?
WHEN WILL YOUR NEXT SALARY REVIEW BE?
DO YOU RECEIVE ANY OTHER BENEFITS/ALLOWANCES THAT INFLUENCE YOUR
SALARY I.E. CELL, CAR, PETROL, MEDICAL AID, TRAVEL ALLOWANCE, OVER TIME,
STAND-BY, SHARE OPTIONS, INSURANCE, COST OF ANY LOANS, BURSARIES AND
INTEREST FREE OR LOW INTEREST LOANS ETC? PLEASE SPECIFY.
DO YOU RECEIVE ANY COMMISSION, HOW IS IT CALCULATED AND WHAT WAS
YOUR AVERAGE COMMISSION RECEIVED OVER THE LAST 6 MONTHS?
DO YOU HAVE ANY COMPANY LOANS / DEBT THAT WILL HAVE TO BE PAID UPON
TERMINATION OF EMPLOYMENT? PLEASE SPECIFY TYPE AND VALUE.
DO YOU HAVE A RESTRAINT OF TRADE?
MEDICAL AID
OPTION / PLAN
NUMBER OF DEPENDENTS
APPLICANT NAME
DATE
Phone: 011 029 0909 - Mobile: 078 801 8689 - Fax: 086 625 5195 - Email: [email protected]
Website: www.femminit.co.za