SOUTH AFRICAN POLICE SERVICE
APPLICATION FOR APPOINTMENT IN AN ADVERTISED POST
THIS FORM IS ONLY APPLICABLE TO POSTS ADVERTISED, ON SALARY LEVELS 1-12 (both Public Service Act and South African Police Service Act
appointment)
SURNAME INITIALS
Post for which you are applying (as it was advertised):
POST NUMBER /
REF NUMBER
(NOTE: THIS IS THE POST NUMBER THAT WILL BE REGISTERED)
Current employer and post that you occupy:
EMPLOYER POST
DID YOU APPLY FOR ANY OTHER POST IN THIS ADVERTISEMENT? YES NO
IF YES, SPECIFY THE POST NUMBERS:
Initial:
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PLEASE ATTEND TO THE FOLLOWING IMPORTANT DIRECTIVES:
· The application form must be completed in your own handwriting. All instructions on the application
form must be adhered to. Failure to do so may result in the application being turned down.
· An original application form and CV must be submitted. Copies will not be accepted.
· This form must be sworned to or affirmed and then be signed in the presence of a Commissioner of
Oath.
· The CV must contain full particulars of all boards on which an applicant serves, remunerated work
outside the public service, career promotions/appointments, career developments, career history,
current studies and qualifications.
· Certified copies of an applicant’s ID document, motor vehicle driver’s licence, all educational
qualifications obtained and service certificates of previous employers stating the post occupied,
must also be submitted and be attached to every application.
· Verification of qualifications will be done and the appointment will be subjected to confirmation of the
qualifications.
· Applicants will be subjected to a vetting process which will include security screening and fingerprint
verification.
· Applications must be mailed timeously, prior to the due date. Late applications will not be accepted
or considered. Applications that do not meet these requirements will not be considered. **
· Correspondence may be conducted with successful candidates only.
· Short-listed candidates will be interviewed only on the date and time specified by the relevant
selection committee.
· In filling the above post, an applicant whose appointment will promote representivity may receive
preference.
· The South African Police Service is not under any obligation to fill a post after it has been
advertised.
· Although the post is advertised, the National Commissioner may withdraw the post from the
advertisement, re-advertise the post or fill the post by transferring a person at the same level where
this is deemed to be in the interest of service delivery.
· The appointment of the successful applicant will come into effect on the first day of the month
following the date on which the National Commissioner approved the appointment.
· Enquiries can be directed to the contact person mentioned in the advertisement.
**(MAIL YOUR APPLICATION AS SOON AS POSSIBLE, AND PREFERABLY 14 DAYS BEFORE THE DUE DATE.IN SOME INSTANCES POSTAL ITEMS TAKE
MORE THAN 21 DAYS TO REACH US. IF YOU SEND YOUR APPLICATION BY COURIER, SEND IT TO OUR DOOR ADDRESS.
EACH APPLICATION, CURRICULUM VITAE (CV) AND REQUIRED DOCUMENTS MUST EITHER BE STAPLED AT THE TOP LEFT-HAND CORNER OR BOUND
ON THE LEFT SIDE. DO NOT USE PAPER CLIPS OR STRINGS.)
A. PERSONAL PARTICULARS
PERSONAL INFORMATION
PERSAL/ FORCE NUMBER (currently in SAPS, SANDF or another Public Service Department)
SURNAME
FIRST NAMES
IDENTITY NUMBER
DATE OF BIRTH AGE
RANK (SAPS or SANDF) TITLE
ARE YOU A SOUTH AFRICAN CITIZEN? YES NO
POSTAL ADDRESS WORK ADDRESS
POSTAL CODE
Initial:
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CODE TELEPHONE (HOME)
CODE TELEPHONE (WORK)
CODE TELEPHONE (FAX)
CELLPHONE EMAIL
AFRICAN M F WHITE M F COLOURED M F INDIAN M F
MARITAL STATUS MARRIED SINGLE DIVORCED
QUALIFICATIONS
HIGHEST GRADE PASSED IN SCHOOL (PLEASE MARK WITH AN X):
BELOW GRADE 10 GRADE 10 GRADE 12
SPECIFY NAME OF SCHOOL
POST SCHOOL QUALIFICATION (IF APPLICABLE, SPECIFY THE FOLLOWING):
INSTITUTION
DEGREE OR DIPLOMA
MAIN SUBJECTS 1. 2.
DRIVER’S LICENSE
DO YOU HAVE A DRIVER’S LICENCE? YES NO Code (as it is
appearing on the
licence card)
DATE THAT THE DRIVER’S LICENCE DAY:……………………… MONTH:…………………………. YEAR:……………………………
WAS ISSUED
EXPIRY DATE DAY:……………………… MONTH:…………………………. YEAR:……………………………
PLACE WHERE LICENCE WAS ISSUED
LANGUAGE PROFICIENCY
LANGUAGE PROFICIENCY — specify level: - good / fair / poor
LANGUAG (1) ENGLISH (2) (3)
SPEAK
WRITE
READ
DISABILLITY
ARE YOU PHYSICALLY DISABLED? (SPECIFY) YES NO
HEALTH
ARE YOU IN GOOD HEALTH?
PHYSICALLY YES NO MENTALLY YES NO
IF YOUR ANSWER TO ANY OF THE ABOVE IS NO, SPECIFY
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ANY OTHER COMMENT(S) CONCERNING YOUR HEALTH
PREVIOUS TERMINATION OF SERVICE (DISCHARGE)
HAVE YOUR SERVICE PREVIOUSLY BEEN TERMINATED? YES NO
IF YES, SPECIFY THE FOLLOWING REASON (SELECT ONE WITH AN X):
RETRENCHMENT MISCONDUCT MEDICAL UNFITNESS SEVERANCE PACKAGE VOLUNTARY RESIGNATION
DATE OF TERMINATION:
IN INSTANCE OF VOLUNTARILY RESIGNATION, WAS THERE A DISCIPLINARY CASE PENDING?
YES NO
(IF YES ABOVE, PROVIDE DETAILS IN A SEPARATE SHEET)
EMPLOYER:
CONFLICT OF INTEREST
ARE YOU INVOLVED IN ANY OUTSIDE BUSINESS OR ACTIVITIES, OR DO YOU HAVE ANY INTERESTS WHICH MAY CONFLICT OR ARE
LIKELY TO CONFLICT WITH THE EXECUTION OF ANY OFFICIAL DUTIES, SHOULD YOU BE THE SUCCESSFUL CANDIDATE FOR THIS
POST?
YES NO
HAVE YOU EVER BEEN DECLARED INSOLVENT? YES NO
CRIMININAL / OFFENCES
HAVE YOU EVER BEEN FOUND GUILTY OF A CRIMINAL OFFENCE? YES NO
DOES YOUR PARTICULARS APPEAR IN PART B OF THE NATIONAL CHILD PROTECTION YES NO
REGISTER (SECTION 126 OF THE CHILDREN’S ACT, 2005) (ACT NO 38 OF 2005) OR THE
NATIONAL SEX OFFENDERS REGISTER (SECTION 42 OF THE CRIMINAL LAW (SEXUAL
OFFENCES AND RELATED MATTERS) AMENDMENT ACT, 2007) (ACT NO 32 OF 2007)? IF YES,
PARTICULARS MUST BE ATTACHED.
HAVE YOU EVER BEEN REFERRED TO A PSYCHIATRIC HOSPITAL IN TERMS OF SECTION 77(6) YES NO
/OR FOUND NOT TO HAVE HAD THE NECESSARY CRIMINAL CAPACITY AND REFERRED TO A
PSYCHIATRIC HOSIPITAL IN TERMS OF SECTION 78(6) OF THE CRIMINAL PROCEDURE ACT? IF
YES, PARTICULARS MUST BE ATTACHED.
IF YES, SPECIFY THE FOLLOWING:
CASE NUMBER: NAME OF POLICE STATION:........................................................................... CAS......./MONTH........../YEAR......................
OFFENCE: (e.g. assault):
SENTENCE IMPOSED (MARK ONE WITH AN X):
IMPRISONMENT SUSPENDED ADMISSION OF GUILT
PERIOD: FROM ..............................(DATE)
PERIOD:...................................... (eg 2 years) AMOUNT: R.............................
TO ................................... (DATE)
HAVE YOU EVER BEEN FOUND GUILITY IN A DISCIPLINARY MATTER? YES NO
IF YES, SPECIFY THE FOLLOWING:
MISCONDUCT: (eg absence without leave): …………………………………………………………………………………………………………………..
SANCTION IMPOSED:
……………………………………………………………………………………………………………………………………………………………………...
………………………………………………………………………………………………………………………………………………………………………
…………….…………………………………………………………………………………………………………………………………………………………
DATE OF SANCTION: …………………………………………………………………………………………………………………………………………...
Initial:
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IS THERE ANY CRIMINAL, CIVIL OR DISCIPLINARY ACTION PENDING AGAINST YOU? YES NO
IF YES, SPECIFY:
CRIMINAL CASE NUMBER: NAME OF POLICE STATION:................................................................CAS......./MONTH........../YEAR.................
MISCONDUCT: (ie assault/ absence without leave): ………………………………………………………………………………………………………..
B. CAREER PROMOTIONS/APPOINTMENTS
YEAR APPOINTMENT/PROMOTIONS
C. CAREER DEVELOPMENT (Training Courses)
YEAR INSTITUTION COURSE PARTICULARS
Initial:
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D. DESCRIBE THE DUTIES THAT YOU ARE PERFORMING IN YOUR PRESENT POST.
E. PREVIOUS WORK EXPERIENCE (From inception to date)
START DATE END DATE COMPANY (INSTITUTION) REASON FOR LEAVING
F. PARTICULARS OF WORK REFERENCES (NOT RELATIVES)
NAME: NAME:
ADDRESS OF COMPANY: ADDRESS OF COMPANY:
POSTAL CODE POSTAL CODE
E-MAIL E-MAIL
Tel. WORK Tel. WORK
FAX FAX
CELLPHONE CELLPHONE
G. CERTIFICATEPARTICULARS OF WORK REFERENCES (NOT RELATIVES)
1. I hereby apply for an appointment to a post in the South African Police Service. I realise that there are a
limited number of posts and that no promises have been made to me about an appointment or posting in the
South African Police Service.
2 After *attestation/appointment in the South African Police Service, I shall perform my duties as an employee of
the South African Police Service to the best of my ability. I undertake to abide by the provisions and
regulations of the Police Service Act, 1995 (Act no 68 of 1995) or Public Service Act, 1994 (Act no 103 of
1994), as applicable. I shall also obey any lawful order or instruction issued in terms of these regulations.
Initial:
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3 I realise that -
3.1 The National Commissioner is under no obligation to fill an advertised post;
3.2 I may have to submit myself to any medical or other tests that are an inherent requirement for the post, and
that may be required to finalise my application for an appointment;
3.3 I have to provide full particulars about my obligations to employers and debts if my application receives further
consideration;
3.4 The South African Police Service will verify my residential address and qualifications as well as citizenship.
3.5 Reference checks will be conducted on all short listed applicants
3.6 If my application does not meet the requirements set out in the advertisement, my application will be turned
down;
3.7 I may be subjected to a security clearance; and
3.8 Interviews with short-listed applicants will take place on the date, time and place determined by the
interviewing panel.
3.9 For appointment in a post which forms part of certain identified categories, I will be subjected to a vetting
process in terms of the prescripts of the Sexual Offences Act, 2007 (Act no 32 of 2007) and the Children’s Act,
2005 (Act no 38 of 2005). If my name appears on either one of the national registers the appointment will not
be considered and deemed as null and void.
4. I certify that the information supplied by me on this *application/statement was made in my own handwriting
and words and that it is in all respects correct and true.
* Delete which is not applicable and initial and date.
I know and understand the content of this statement (application form).
I have (no) objection(s) to taking the prescribed oath.
I (do not) consider the prescribed oath to be binding on my conscience.
I affirm that the content of this statement (application form) is true.
DATE: ......................................................................
PLACE: ………….........................................................
.......................................................................................
SIGNATURE OF APPLICANT
I certify that the deponent has acknowledged that he/she knows and understands the content of this statement which
was sworn to/affirmed before me and the deponent’s signature was placed thereon in my presence.
ON THE................... DAY OF.............................................................................. (year) 20........... AT.........................
PLACE: ......................................................................
…………………………….............................................
SIGNATURE OF COMMISSIONER OF OATHS
Initial:
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