Application Form: HRMC 11/25/10 - SECURITY OFFICER If you are offered the position, when can you start OR how much notice must you serve with your current employer? * Personal Details Are you a South African Citizen?. If no, what is your nationality? * No Yes ID Number: * Nationality : Select Nationality ...AfghanAlbanianAlgerianAmericanAndorranAngolanAnguillaAntarcticaAntigua and BarbudaArabArgentinianArmenianArubaAustralianAustrianAzerbaijanBahamasBahrainBangladeshBarbadosBelarussianBelgianBelizeBeninBermudaBhutanBolivianBosnianBotswanianBouvet IslandBrazilianBritishBruneian DarussalamBulgarianBurkina FasoBurundiCambodianCameroonCanadianCapeverdeCayman IslandsCentral African RepublicChadianChileanChineseChristmas IslandCocos IslandsColombianComouenneCongoleanCongolian(DRC)CookIslandsCosta RicanCôte d¿IvoireCroatianCubanCypriotCzeckDanishDependent Territories Citizen (British)DjiboutiDominicanDutchEast TimorEcuadorianEgyptianEritreanEstonianEthiopianFalkland IslandsFaroe IslandsFijianFinnishFrenchFrench GuianaGabonaiseGambianGeorgianGermanGhanaianGreekGreenlandGrenadianGuadeloupeGuamGuatemalaGuinea BissauGuineanGuyanaHaitianHeard and McDonald IslandsHonduranHungarianIcelanderIndianIndonesianIranianIraqiIrishIsraeliItalianJamaicanJapaneseJordanKazakhstanKenyanKiribatiKoreanKosovoKuwaitiKyrgyzstanLao People¿s Democratic RepublicLatvianLebaneseLesothoLiberianLibyan Arab JamahiriyaLiechtensteinLithuanianLuxembourgMacauMacedonianMadagascarMalawiMalaysianMaldivianMaliMalteseMarshall IslandsMartiniqueMauritaneanMauritianMayotteMexicanMicronesian (Federated States of)MonacoMongolianMontserratMoroccanMozambiqueMyanmeseNamibianNational Overseas (British)NauruanNepaleseNeutral ZoneNew CaledonianNew ZealanderNicaraguanNiger(INCORRECT-DO NOT USE)Nigerian(Nigeria)Nigerien(Niger)NiueNorfolk IslandNorth KoreanNorthern Mariana IslandsNorwegianOmanOverseas Citizen (British)PakistaniPalauPalestinianPanamianPapua New GuineaParagaianPerson of Unspecified CAT_NATIONALITYPeruvianPhilippinePitcairnPolishPortugueseProtected Person (British)PuertoricanQatarRefugeeRepublic of MoldovaReunionRomanianRussianRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSalvadorianSamoanSamoan AmericanSan MarinoSao Tome and PrincipeSaudiarabianSenegaleseSerbianSeychelloiseSierraleoneSingaporeanSlovakSlovenianSolomon IslandsSomalianSouth Georgia and the South Sandwich IslandsSouthafricanSpanishSrilankanSt HelenaSt Pierre and MiquelonStateless PersonSudaneseSurinameSvalbard and Jan Mayen IslandsSwazilanderSwedishSwissSyrianTajikistanianTanzanianThaiTogoTokelauTongaTrinidad and TobagoTunisiaTurkishTurkmenistanTurks and Caicos IslandsTuvaluUgandianUkraineUnited NationsUruguaianUtopianUzbekVanuatuVatican City State (Holy See)VenezuelanVietnameseWallis and FutunaWesternsaharaYemenZambianZimbabwean Passport Number : * Passport number in the case of non- South Africans. Do you have a valid work permit? (only if non-South African) No Yes Name: * Surname: * Email Address: * Date of Birth: * Province: * Select Province ...Eastern CapeFree StateGautengHead Office (Tshwane)KwaZulu NatalLimpopoMpumalangaNorth WestNorthen CapeWestern Cape City: * No records found. Race: * Select Race ...AfricanColouredIndianOtherWhite * This information is required to enable the department to comply with the Employment Equity Act, 1998. Gender: * Select Gender ...FemaleMale * This information is required to enable the department to comply with the Employment Equity Act, 1998. Do you have a disability?. If yes, Provide the nature of your disability. * No Yes Disability Type : Select Disability Type ...Hearing DisabilityMental DisabilityOther Please SpecifyPhysical DisabilityVision DisabilityVisual Disability Contact Details Method for correspondence: * Select Contact Type ...E-mailFaxOtherPostTelephone Telephone (Mobile) details * Alternative Method for correspondence: Select Alternative Contact Type ...E-mailFaxOtherPostTelephone Contact details Do you have a driver's licence permit? * No Yes License Code Select License Code ...Code ACode BCode CCode C1Code EBCode ECCode EC1 Do you have a professional driving permit (PDP)? No Yes PDP Expiry Date Have you been convicted or found guilty of a criminal offence (including an admission of guilt)? No Yes Criminal Offence Details * The Executive Authority shall consider the criminal record (s) against the nature of the job functions in line with internal information security and disciplinary code. Do you have any pending criminal case against you? No Yes Case Details Have you ever been dismissed for misconduct from the Public Service? If yes (provide the details) No Yes Misconduct Details * This information will only be taken into account if it directly relates to the requirements of the position. Have you resigned from a recent job pending any disciplinary proceeding against you? If yes, (please note that the provisions of the Public Service Act shall apply). No Yes Disciplinary Details * This information will only be taken into account if it directly relates to the requirements of the position. Do you have any pending disciplinary case against you? No Yes Case Details * This information will only be taken into account if it directly relates to the requirements of the position. Have you been discharged or retired from the Public Service on grounds of Ill-health or on condition that you cannot be re-employed? No Yes * This information will only be taken into account if it directly relates to the requirements of the position. Are you conducting business with the State or are you a Director of a Public or Private company conducting business with the State? If yes, (provide the details) No Yes Nature of Business In the event that you are employed in the Public Service, will you immediately relinquish such business interests? No Yes Does your profession or occupation require State or official registration? No Yes Registration Date Registration No If you were previously employed in the Public Service, is there any condition that prevents your re- appointment? If yes, Provide the name of the previous employing department and indicate the nature of the condition. No Yes Employing Department and Condition Total number of years of experience you have * * in Private Sector * in Public Sector Language Proficiency Formal Qualifications Work Experience References NB: Add at least three references Upload PDF Documents Upload Z83 Upload CV Upload Other NB: (Max 5 PDF files) View Declaration Submit Application Quit