careers

EMPLOYMENT APPLICATION FORM

PLEASE PRINT ALL INFORMATION REQUESTED EXCEPT SIGNATURE

Page 1
Job description
Personal Details
Surname
Firstname
Present Physical Address
Number
Street
City
State/Province
PostalCode
Present Postal Address
Box
City
State/Province
Code
Citizenship
Are you a citizen of South Africa? Yes No
Do you have permanent residency status? Yes No
Identity No.
Passport No.
Telephone:
Home (include code)
Office (include code)
Cellular
current salary (1) (benefits)
and salary desired (2) (benefits)
Are you available to work shifts? Yes No
Employment desired FULL-TIME ONLY
PART-TIME ONLY
FULL- OR PART-TIME
Notice Period
Education:
SCHOOL TYPE NAME OF SCHOOL LOCATION
(Complete mailing address)
YRS MAJOR & DEG
High School
College
Bus. or Trade School
Professional School
HAVE YOU EVER BEEN CONVICTED OF ANY CRIMES? (Must be relevant to job requirements) Yes No
If yes,explain number of conviction(s), nature of offense(s) leading toconviction(s), how recently such offense(s) was/were committed, sentence(s)imposed, and type(s) of rehabilitation.

Page 2
APPLICATION FOR EMPLOYMENT
Drivers License
DO YOU HAVE A DRIVER’S LICENSE? Please ensure that the Driver's License Record Check is completed. Yes No
What is your means of transportation to work?
TO BE COMPLETED BY APPLICANTS FOR OFFICE WORK ONLY
Word Processing Software MS Office Lotus Office Suite
WordPerfect Pastel
Other
Other Computer / Programming / DTP Skills
Reference
Please list three references.
Name
Position
Company
Address

Code
Telephone
Name
Position
Company
Address

Code
Telephone
Name
Position
Company
Address

Code
Telephone

Page 3
APPLICATION FOR EMPLOYMENT
Work Experience
Please list your work experience for the past five years beginning with your most recent job held. If you were self-employed, give firm name. Attach additional sheets if necessary. Applicant employees will be required to sign an Information Release Form for the following reference checks: Educational Record Check, Personal Reference Check, Driver's License Check and Employment Record Check.
Company (1)
Employment dates
Pay or salary
Name of last supervisor/manager
Your last job title
No. of Subordinates
Reason for leaving (be specific)
List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.
Company (2)
Employment dates
Pay or salary
Name of last supervisor/manager
Your last job title
No. of Subordinates
Reason for leaving (be specific)
List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.
Company (3)
Employment dates
Pay or salary
Name of last supervisor/manager
Your last job title
No. of Subordinates
Reason for leaving (be specific)
List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.
Company (4)
Employment dates
Pay or salary
Name of last supervisor/manager
Your last job title
No. of Subordinates
Reason for leaving (be specific)
List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.

Page 4
PLEASE READ CAREFULLY
May we contact your present employer? Yes No
Did you complete this application yourself Yes No
If not, who did
APPLICATION FORM WAIVER (FOR SA ONLY)
In exchange for the consideration of my job application by Total Relationship Management (hereinafter called "the Company"), I agree that:

Neither the acceptance of this application nor any subsequent interview, either for the position applied for or any other position, and regardless of the contents of employee handbooks, personnel manuals, benefit plans, policy statements, and the like as they may exist from time to time, or other Company practices, shall serve to create an actual or implied expectation of an offer of employment. If employed, I understand that the Company may unilaterally change or revise their benefits, policies and procedures and such changes may include reduction in benefits.
I have read and agree to above terms Yes No Date: 05 Sep 2010
This Company is an equal employment opportunity employer. We adhere to a policy of making employment decisions without regard to race, colour, religion, sex, sexual orientation, national origin, citizenship, age or disability. We assure you that your opportunity for employment with this Company depends solely on your qualifications and the inherent requirements of the job, having regard to Employment Equity legislative requirements.
Thank you for completing this application form and for your interest in our business.

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0861 TRM TRM
or 011 265 1850
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086 686 8382
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