Application for Employment Form

KNATCOM. 1A

APPLICATION FOR EMPLOYMENT FORM

To be completed by the applicant. (THIS FORM SHOULD NOT BE MODIFIED WHATSOEVER)

1. Vacancy/Post Information

Vacancy/Post:
Vacancy/Post Advert No:
Grade:
Present Gross Salary:
(attach latest pay slip)
Specify expected Minimum Gross Salary:

I will be able to report to work ………….... days after I am hired.

2. Personal details

Salutation
Surname
First Name
Other names
Age
Date of birth
Gender
Nationality
ID/No. Passport No.
(attach copy)
Ethnicity
Languages spoken
Current Office Address / Postal Code
Town
County
Constituency
Home Address / Postal Code
Town
County
Constituency
Telephone (Landline)
Mobile
Email Address
Alternative Contact Person / Name:
Telephone:
Are you a person living with Disability?
/ Yes
No
Are you a serving Officer (In the Public Service? / Yes
No
If yes, what are your terms of service / Permanent
Contract
Have you ever been dismissed from employment? / Yes
If yes, Please explain
No
Have you ever been convicted by a court of law? / Yes
If yes, Please explain
No

3. Educational and Professional Background

i. Please list your academic history and attach copies of the same.

Level of School / Name of Institution / Year of Admission / Year of Graduation / Area of specialization / Certification Awarded / Certificate Number
Primary School
O – level
A – Level
Diploma / (attach copy)
Higher Diploma / (attach copy)
Degree / (attach copy)
Masters / (attach copy)
Doctorate / (attach copy)
Others specify / (attach copy)

ii. Do you possess original copies of the above certificates?

(Tick/shade one)

Yes
No

iii. Are you currently undertaking any study/training?

(Tick/shade one)

Yes
No

iv. Course/program name:

v. Indicate whether

Full-time / Part-time / Distance / Other

4. Employment History (START WITH MOST RECENT PLEASE)

Please list your work experience beginning with your most recent job held. Include temporary jobs. Be sure all your experience or employers related to this job are listed here (add more rows if needed)

Name of Employer / Date of Employment / Total No of years worked / Position held / Terms of Service
(contract, temporary, permanent etc.) / Reason for exit (be specific)
From / To

i. May we contact any of your previous employers?

(Tick/shade one)

Yes
No

5. Work Experience History

i. Personal Level Experience

Please list what you consider to be your personal achievements from the previous jobs held (add more rows if needed)

Name of Organization worked for / Position held / Year / Specify the significant milestones achieved in that organization

ii. Organizational Stewardship Experience

Please list the key organizational achievements/milestones that resulted under your leadership (add more rows if needed)

Name of Organization / Leadership Position held (Acting or substantive) / Year / Specify the key outstanding milestones achieved by the organization through your stewardship / Commendations/rewards awarded (if any)

iii. International level Experience

Please list the nature of international forums attended and specify your personal contribution to it (add more rows if needed)

Name of sponsoring Organization / Specify Nature of international forum attended (meeting, conference, training, exhibition etc.) / List any Positions held (if any) / Specify your individual role in that forum

iv. Programme/Project Management Experience

Please list the major national level programmes or projects you have been involved in the course of employment (add more rows if needed)

Sector
(Education, Sciences, Culture or ICT) / Programme/project title / Specify Programme/project Financier / Specify your individual assignment in the programme/project

v. Policy Formulation Experience

Please list the major national/international policy instruments that you have participated in their formulation at organizational, national or international levels (add more rows if needed)

Level
(organizational, national or international) / Name of policy instrument/document / Year / List your specific task in that formulation process

6. Compliance with Constitutional Obligations

Please confirm that you have cleared with the following institutions

Name of organization / (Tick/shade one)
HELB
KRA
Ethics & Anti Corruption Commission
CID

7. Computer Application Skills

Please provide a self assessment of your level of computer literacy

Type of Application / Degree of competency
Word Typing / Not Good
Somewhat
Good
Very Good
Power point / Not Good
Somewhat
Good
Very Good
Use of IPAD / Not Good
Somewhat
Good
Very Good

8. Strategic leadership Certification

Please provide information on the nature of strategic leadership development or management course you have attended

Name of Institution / Title of Certificate / Duration / Date of issue

IMPORTANT INFORMATION

Use the space below in BULLET/NUMBER FORM to summarize any other additional information necessary to describe your full qualifications for the specific position for which you are applying (add more numbers if needed)

9. References

(Reference checks will be conducted legally in an ethical manner and all information derived will remain confidential)

i. Do you agree to have referees contacted in relation to this application?

(Tick/shade one)

Yes
No

ii. Please provide details of three people who can speak on your behalf regarding your work history other than relatives.

Name of Referee / Position / Company/Organization / Address / Telephone

INFORMATION TO THE APPLICANT

As part of our procedure for processing your employment application, your personal and employment references may be checked. If you have misrepresented or omitted any facts on this application, and are subsequently hired, you may be discharged from your job.

DECLARATION

I understand that this application does not constitute an offer of employment. I understand that inaccurate, misleading or untrue statements or knowingly withheld information may result in termination of employment with this organization. I hereby certify that I have not knowingly withheld any information that might adversely affect my chances for employment and that the answers given by me are true and correct to the best of my knowledge. I further certify that I, the undersigned applicant, have personally completed this application. I understand that any omission or misstatement of material fact on this application or any other document used to secure employment shall be grounds for rejection of this application or for immediate discharge if I am employed, regardless of the time elapsed before discovery.

Signature of Applicant Date

KNATCOM is an equal employment opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, religion, sex, ethnicity, age, or disability. We assure you that your opportunity for employment with KNATCOM depends solely on your qualifications.

Thank you for completing this application form and for your interest in our organization.