PDSA HR 09 C PDSA External Application Form 08.10.21 2
PDSA HR 09 C PDSA External Application Form 08.10.21 2
Revision: 8
Page 1 of 2
Are you currently working at one of the Petra Diamonds Operations YES NO
Which Operation are you working at (e.g. Cullinan, Finsch, Koffiefontein
or PDSA)
If you are not employed by Petra Diamonds, please indicate your Current
Employer
SECTION B - APPLICANT’S PERSONAL DETAILS – please note the minimum age for employment is 18 years.
SURNAME TEL. NO. (HOME)
FULL NAMES CELL NUMBER
PREFERRED NAME TEL. NO. (WORK)
E-MAIL ADDRESS TEL. NO. (FAX)
TITLE PROF DR MR MRS MISS
GENDER MALE FEMALE DRIVERS LICENCE YES NO DRIVERS LICENSE CODE
NATIONALITY ID NUMBER
MARITAL STATUS MARRIED SINGLE DIVORCED WIDOWED DATE OF MARRIAGE
IF YES PLEASE
DO YOU HAVE A DISABILITY? YES NO EXPLAIN
Monthly Current Cost to Company Monthly Expected Cost to Company
(optional) (optional)
5
6
CONSENT / DECLARATION
I hereby voluntarily consent for security vetting (including qualification, criminal and credit checks) to be carried out on
me by the Company prior to and during employment/access/doing business with the Company and agree that it is done in
accordance to legislation.
I accept that the security vetting process is part of the screening process and that the Company is under no obligation to
employ me upon completion of the security vetting process.
I am also aware of the fact that the information gathered by the Company or their duly appointed vendor/s will be dealt with
on a strictly confidential and discreet basis, and that such information may be shared with the Company and that the
Company will be entitled to retain the information obtained for record keeping purposes.
I unconditionally indemnify the Company or their designated vendor/s they used to obtain relevant information, against
liability.
Furthermore, I am aware that the authorized security vetting process involves compiling comprehensive background checks,
which will be used to finalise a decision regarding my application for employment.