Please complete this form and click "submit",

Or, you can download this form and fax it to 021 638 2525.

personal details
title
first name surname
email address cell/mobile number
home number   other number  
id number date of birth (dd/mm/yyyy)
age shirt size  small
 medium
 large
 x-large
referred by

emergency contact
name & surname relationship
email cell/mobile number
home number   other number  

address details
flat / house number
street name
suburb
town
postal code

availability

Any time Weekends Evenings Public holidays School holidays Other

transport

Own Public Rely on lifts Other
(please specify)

languages spoken


computer literacy

Are you comfortable using a computer?
Yes No
Programmes you can use?
Word Excel Power point Other
(Please specify)
Data capturing, words per minute
Other skills

education
Secondary Education
School:
Grade:
Subjects:
Tertiary Education
Institution:
Year of study:
Years left:
Studying for
(Degree, Diploma, Course):
What is it called?:

employment history

(past five years)
Employer:
From (MM/YYYY):
To (MM/YYYY):
Job description:
Duties:
Reason for leaving:
Person reported to:
Employer:
From (MM/YYYY):
To (MM/YYYY):
Job description:
Duties:
Reason for leaving:
Person reported to:
Employer:
From (MM/YYYY):
To (MM/YYYY):
Job description:
Duties:
Reason for leaving:
Person reported to:

general


Why do you want to join Amanzi Blue ?
Declaration of Understanding.

 I understand that Amanzi Blue, through employing me on various jobs, place me in a position of trust and I undertake to always maintain a level of confidentiality. further agree never to solicit or accept employment directly from Amanzi Blue clients, unless 180 days have elapsed since last working for said client or have made arrangements via Amanzi Blue. Failure to comply will result in Amanzi Blue not offering further employment and taking up the matter with the client.