NECOR ZAMBIA LIMITED
Lonrho House, Cairo Road, P O Box 31465, Lusaka
Tel: +260 1 229782 Fax: +260 1 226772
Email:
[email protected] EMPLOYMENT DATA
CONFIDENTIAL
This form must be completed in full. False information will render subsequent employment opportunity
/contract null and void.
1 Position Applied
For
2 Alternate Position
of Interest (If Any)
3 Surname
Forenames
4 Gender Date of Birth
5 Marital Status No. of Children
6 Nationality NRC/ or Passport #
7 Postal Address Guardian P O. Box No. Town
/Company
8 Residential Plot No. Street Township
Address
9 Email Address
10 Contact Nos Tel Mobile
11 State of Health Illnesses Allergies
(indicate illness or
allergies you may
be suffering from):
12 Disabilities (If
Any)
13 Any other data
EDUCATION BACKGROUND
SECONDARY SCHOOL DATES EXAMINATIONS PASSED
/COLLEGE /UNIVERSITY FROM TO
2
3
Education Background Continued ……..
4
5
PROFESSIONAL QUALIFICATIONS
(Details of special training, professional or other qualifications, certificates etc...)
INSTITUTION DATES EXAMINATIONS PASSED
FROM TO
1
2
EMPLOYMENT BACKGROUND
1 PRESENT EMPLOYER ADDRESS
POSITION HELD FROM TO
2 GROSS PAY OTHER ALLOWANCES
3 OTHER BENEFITS
TYPE
VALUE
REASONS
FOR
WISHING
TO LEAVE
What period of Notice are you supposed to give?
OTHER PREVIOUS POSTION FROM TO GROSS PAY
EMPLOYERS
1
2
Previous Employers continued ……
3
5
Reason for leaving last employment
If not working indicate occupation
Do you have a valid drivers’ license?
Assuming you are successful, when
would you be ready to start work?
EXPECTATIONS
1
What is your expected gross pay?
A What are your other expectations?
B
C
A INTERESTS /PASS
TIME ACTIVITIES
/HOBBIES
B LANGUAGES
SPOKEN
1 SPECIAL
2 ACHIEVEMENTS
3
SPECIAL 1
ATTRIBUTES 2
3
4
5
REFEREES
(Please give three names and addresses of people in position of responsibility who have known you for at least
two years but are not related to you).
NAME PROFESSION ADDRESS CONTACT NO.
1
2
3
Applicant’s Signature Date:
