PDSA HR 09 C PDSA External Application Form 08.10.21 2

Annexure PDSA-HR-09 (C)
Revision: 8
Page 1 of 2
EXTERNAL JOB APPLICATION FORM

Please note that Petra Diamonds never requires any form of payment for recruitment purposes. If you are approached in
this regard, you should report the incident immediately via one of the following hotlines:
SA Toll Free: 0800 007 247; Phone: +27 31 571 5573; Email: [email protected];
Post: KZ 138, Umhlanga Rocks, 4320; Website: www.tip-offs.com
Please note the following documentation must accompany this application (where applicable): Applicant’s ID,
Qualifications, Driver’s License and a CV (NO APPLICATIONS WILL BE CONSIDERED WITHOUT THESE DOCUMENTS).
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 A – JOB DETAILS
NAME OF POSITION APPLIED FOR ADVERT REF NUMBER

IS THE POSITION ADVERTISED PERMANENT TEMPORARY FTC ADVERT CLOSING DATE
ARE YOU CURRENTLY EMPLOYED YES NO IF YES, PLEASE INDICATE NOTICE PERIOD
RECRUITMENT ACENCY NAME CONTACT PERSON AT
(if applicable) AGENCY
AGENCY E-MAIL ADDRESS AGENCY CONTACT

NUMBER
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)
SECTION C - APPLICANT’S CURRENT ADDRESS DETAILS

POSTAL ADDRESS PHYSICAL ADDRESS
CITY CITY
PROVINCE PROVINCE
POSTAL CODE POSTAL CODE
SECTION D - APPLICANT’S HIGHEST SCHOOL QUALIFICATION

NAME OF HIGH SCHOOL
HIGHEST STANDARD / GRADE PASSED YEAR PASSED
SECTION E - APPLICANT’S TERTIARY QUALIFICATION DETAILS – RELEVANT TO THE POSITION

HIGHEST QUALIFICATION YEAR OBTAINED
INSTITUTION OBTAINED FROM
Petra Diamonds (Pty) Ltd

Revision: 8
Page 2 of 2
TRADE TEST QUALIFICATIONS (IF APPLICABLE)

TRADE TEST (SPECIFY TRADE) YEAR OBTAINED
INDICATE INSTITUTION WHERE TRADE TEST

TRADE TEST WAS OBTAINED CERT NO
INDICATE TRAINING PATH / Indicate Engineering
SECTION OBTAINED (Section 13, Industry (QCTO, MQA,
Section 26D or Section 28) MIETTB, MERSETA)
SECTION F – FURTHER OR CURRENT STUDIES

ARE YOU STUDYING AT PRESENT? YES NO IF YES, WHAT ARE YOU STUDYING?
NAME OF INSTITUTION WHERE YOU ARE STUDYING?
CURRENT YEAR OF STUDY INTENDED END DATE OF STUDY
SECTION G - APPLICANT’S LANGUAGE ABILITY

INDICATE LANGUAGE READ WRITE SPEAK
1
2
3
SECTION H - ADDITIONAL COURSES

COURSE NAME INSTITUTION NAME YEAR OBTAINED
SECTION I - EMPLOYMENT HISTORY - START WITH CURRENT/MOST RECENT EMPLOYMENT

REASON FOR NAME & CONTACT
START DATE END DATE TERMINATION SURNAME NUMBER OF
NAME OF EMPLOYER POSITION HELD
DD/MM/YYYY DD/MM/YYYY OF REFERENCE REFERENCE
EMPLOYMENT PERSON PERSON
1
2
3
5
6
SECTION J – ANY ADDITIONAL INFORMATION / COMMENTS NOT COVERED IN SECTIONS ABOVE

Revision: 8
Page 3 of 2
SECTION K - APPLICANT DECLARATION / CONSENT

PERSONAL INFORMATION
I declare that the information on this form is correct and I acknowledge / understand that any false declaration or
misrepresentation of facts in this application may render any employment agreement with Petra Diamonds (Pty) Ltd null and
void.
I further declare that all Personal Information supplied to the Company for the purposes of recruitment, testing and
assessments, security vetting and related Human Resources reasons is accurate, up-to-date, is not misleading and that it is
complete in all respects. I furthermore give the Company permission to process my Personal Information, as provided
above, and acknowledge that I understand the purposes for which it is required and for which it will be used.
Consequences of Withholding Consent or Personal Information - should you refuse to provide the Company with the
required consent and / or information, the Company will be unable to assist you with your employment / and or recruitment
requirements.
Please note - All Personal Information that you provide to the Company will only be used for the purposes for which it is
collected.
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.
APPLICANT’S NAME AND SURNAME
APPLICANT’S SIGNATURE DATE

PDSA HR 09 C PDSA External Application Form 08.10.21 2

Uploaded by

Document Information

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

PDSA HR 09 C PDSA External Application Form 08.10.21 2

Uploaded by

Copyright:

Available Formats

Annexure PDSA-HR-09 (C)

EXTERNAL JOB APPLICATION FORM

SECTION A – JOB DETAILS

NAME OF POSITION APPLIED FOR ADVERT REF NUMBER

AGENCY E-MAIL ADDRESS AGENCY CONTACT

SECTION C - APPLICANT’S CURRENT ADDRESS DETAILS

SECTION D - APPLICANT’S HIGHEST SCHOOL QUALIFICATION

SECTION E - APPLICANT’S TERTIARY QUALIFICATION DETAILS – RELEVANT TO THE POSITION

Petra Diamonds (Pty) Ltd

TRADE TEST QUALIFICATIONS (IF APPLICABLE)

INDICATE INSTITUTION WHERE TRADE TEST

SECTION F – FURTHER OR CURRENT STUDIES

SECTION G - APPLICANT’S LANGUAGE ABILITY

SECTION H - ADDITIONAL COURSES

SECTION I - EMPLOYMENT HISTORY - START WITH CURRENT/MOST RECENT EMPLOYMENT

SECTION J – ANY ADDITIONAL INFORMATION / COMMENTS NOT COVERED IN SECTIONS ABOVE

Petra Diamonds (Pty) Ltd

SECTION K - APPLICANT DECLARATION / CONSENT

APPLICANT’S NAME AND SURNAME

APPLICANT’S SIGNATURE DATE

Petra Diamonds (Pty) Ltd

You might also like