KENYA ASSOCIATION OF PROFESSIONAL COUNSELLORS

School of Counselling Studies

Employment Application Form

VACANCY: ______

APPLICATION FOR EMPLOYMENT

When completed, the form should be returned with copies of your certificates to the:-

The Executive Director

School of Counselling Studies

Kenya Association of Professional Counsellors

P. O. Box 55472 -00200

Nairobi

Kenya

PLEASE TYPE OR USE BLOCK CAPITALS IN BLACK INK AND WRITE INSIDE THE BOXES

BIOGRAPHICAL INFORMATION

Surname/Family Name / Title (Dr/Mr/Mrs/Miss/Ms)
First/given name(s) / Date of Birth
Male(M) Female (F) / Country of Birth / Nationality

Permanent Address

Post code: -

Daytime Phone Number

(Including STD/Area code)

Mobile phone number:Fax Number:

Email:

Address for correspondence (If different from permanent address)

EMPLOYMENT INFORMATION:

Employment/work experience. (Please attach your CV)

Please put in as much information as possible here, if appropriate going back 10 years, and continue on a separate sheet if you need more room

Position / Employer / Nature of Work / Dates

Give reasons for your interest in this job advertisement

Give reasons why you think you qualify for this job advertisement

_

Preferred mode of work Full time Part time Other

(Please tick appropriate box)

Proposed date of employment ………………………………………………………………………………………

ACADEMIC INFORMATION

List all schools, colleges or universities you have attended, or are now attending.

School/College/University / Start Date Month/Year / Completion date
Month/Year / Major subject / Qualification
(with class/grade received / Date of award

Professional or other qualifications received

Academic honours, distinctions, prizes or other awards you have received

ENGLISH LANGUAGE PROFICIENCY

First language

Have you previously studied and been assessed in English Language? If so, please state when and where, and the qualification(s) achieved.

ADDITIONAL INFORMATION How did you find out about this job vacancy at KAPC?

Please tick appropriate box

Prospectus / Advert in Newspaper/ Journal / Education Fair / University/college careers service
World Wide Web / Personal recommendation / Other (please specify)

DATA PROTECTION

The information contained in this application will be used for the purpose of processing your application and if you are admitted, will form part

of your KAPC employment record. All data is held and processed in accordance with the requirements of the Data Protection Act, and

within the limits agreed with the KAPC Data Protection Officer.

DECLARATION:

I certify that the information given in this application and in the support documents is accurate and complete. I understand that the submission of

Inaccurate information may be sufficient cause for refusal of admission or termination of registration.

SignatureDate

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

FOR OFFICE USE ONLY

Application No
Date Sent / Date Received
Accept / Defer / Reject