Rallim Careers Application Form Personal Information First Name/s : ID Number : Last Name : Date of Birth : Email Address : Gender : --- SelectMaleFemalePrefer not to say Race --- SelectBlackWhiteColouredIndianOther Home Address : Postal Code : City : Previous Next Contact numbers Current office phone: Cell phone: Home phone: Other: Previous Next General information Current Salary Upload Payslip Nationality: Marital status: Next of kin Name: Do you have a valid driver’s license? YesNo Do you have a residence permit? YesNoNon SA Citzen Do you hold a PDP? YesNo Are you registered with SACE? YesNo Do you have your own transport? YesNo Do you hold a police clearance certificate? YesNo Do you have family working in Rallim? YesNo Do you have children attending Rallim? YesNo Ages of children (If Applicable) : Next of kin Number Place of birth: Previous Next Attachments Document Title Attachment Type --Select--Attached resume/CVAttached SACE registration (If applicable)Attached Police ClearanceAttached Proof of qualification. File -+ Previous Next Employment Specific SACE number: Registration Date Attacth SACE registration Position applying for: Phases teaching in: (Current position hold) Grade/s teaching: Subject specialty: (If applicable) Additional teaching subjects: Additional languages: Sporting codes (coaching) or other co-curricular school activities with which you are willing to assist: Years of teaching experience: Years of managerial experience: Year of teaching and managerial experience that are concurrent: Availability/ Notice period required: Previous Next Qualification PROFESSIONAL QUALIFICATIONS: (Start with highest and date each qualification): Qualifcation Qualification Date Qualification Institution Duration Of Study Attach proof of qualification -+ ACADEMIC QUALIFICATIONS: (Start with highest and date each qualification): Qualifcation Qualification Date Qualification Institution Duration Of Study Attach proof of qualification -+ Previous Next Do you consent for us to conduct comprehensive screening and checks? YesNo I hereby give my full consent to Rallim Preparatory and its agents to conduct a comprehensive background check on me (including but will not be limited to my financial and credit record, medical and work history as well as any other record check as is deemed necessary). I give this consent of my own free will. Previous Next Have you ever suffered from any of the following illnesses? Asthma, bronchitis, tuberculosis, lung disease or any other chest disease YesNo State Illness Heart disease, high blood pressure YesNo State Illness Peptic ulcer or other digestive or stomach/bowel disorders YesNo State Illness Jaundice/Hepatitis or other liver disorders YesNo State Illness Kidney or bladder disorders YesNo State Illness Diabetes, thyroid or other gland problems YesNo State Illness Hay-fever, allergies to drugs, animals etc YesNo State Illness Any alcohol or drug related problems or illnesses YesNo State Illness Any other medical condition, physical or mental, not mentioned above, please state. YesNo State Illness Appendix to application for employment (Must be completed by all candidates) Family members, relatives and other relations It is expected of candidates to declare any family ties, close relations or blood relationships with staff members of Rallim Modern Learning Environment. DEFINITION Family members: people, normally with the same surname, and from one household, such as husband and wife, parents and children, adopted children, brothers and sisters. Relatives: parents and children, in-laws (parents and children), brothers and sisters. Blood relationship: any person who is related by birth to the same family. Other: any other form of relation. Statement I declare any relations with staff members of Rallim Modern Learning Environment as follows: I declare the information herein to be complete and true. Δ
