If you are applying for more than one post you must use a different form for each application Type in the white boxes only Post applied for:

Full name (with family or last name in capitals): Title (e.g. Mr, Mrs, Miss, Ms, Dr) How did you find out about this vacancy?

Nationality, residency, mobility and security clearance – read this note before answering the questions below

1. The successful applicant will need to have the right to live and work in Kenya – is legally free to work in Kenya and able to provide proof of nationality / residency. 2. The successful candidate will need to undertake a basic security check which will include background checks - confirmation of identity; nationality and immigration status, confirmation of employment history provision of references from previous employers over past 3 years plus a criminal record check. I can demonstrate my eligibility for this post and am prepared to meet the additional requirements laid out above. Please indicate yes/no.

Personal Details
Permanent address, including postcode: Mailing address, if different:

National Identification Card Number or Passport & Residency Permit Details Email (this will be our main form of communication): Daytime telephone/mobile number: Evening telephone number/ mobile (if different from above): Qualifications – Educational Qualifications-Educational 1 Qualification Titles: Grade or Level: Examining Body: Qualifications-Educational 2 Qualification Titles: Grade or Level: Examining Body: QUALIFICATIONS.Nationality. .PROFESSIONAL Please provide details of any professional training or qualifications you have obtained which may be relevant for this position and any professional associations of which you are a member.

Dates employed 4. To: 5. Please account for any intervals. . Dates employed 4. unemployment etc 1. Dates employed 4. reporting relationships. Reason for leaving Previous employment 1. 3. skills and achievements 5.From: 4. Employer’s name and address 2. . 3. Your position / Job title 3. Reason for leaving Previous employment 1. 1.Career History Please describe your career to date. Your position / Job title 3. 2. reporting relationships. Current employment 1. Your position / Job title 3. From: 4. reporting relationships. To: 5. To: 5. From: 4. From: 4. Briefly outline the role you were performing. Your position / Job title 3. and complete the details. 2. Dates employed 4. Briefly outline the role you were performing. career breaks. 2. on a separate sheet of paper. 1.. 2. Briefly outline the role you were performing. To: 1. Employer’s name and address 2. Employer’s name and address 2. if necessary. Please indicate clearly any service or work overseas and state the country. skills and achievements Previous employment 1.g. Reason for leaving Time unaccounted for: Please state any periods unaccounted for e. skills and achievements 5. starting with your most recent employment first and work in reverse order. skills and achievements 5. reporting relationships. 3. Briefly outline the role you were performing. Employer’s name and address 2. 3.

Please provide evidence against each of the competencies listed in the job description. knowledge and experience demonstrate your suitability for this post.LANGUAGES Please indicate your level of fluency against each of the following: 1 = fluent 2 = moderate 3 = basic Language Read Write Speak Understand PERSONAL QUALITIES and SKILLS REQUIRED (PERSON SPECIFICATION) Please refer to the job description essential/desirable skills/experience and say in no more than 1500 words how your skills. abilities. . REASONS for APPLYING Please say in no more than 500 words why you are applying for this post.

or if you withhold relevant if you have already been appointed. please sign below to affirm that the information you have provided is to the best of your knowledge true and If you provide any information which you know is false. .DECLARATION When you are satisfied you have completed all the questions fully. to your dismissal. this may lead to your application being rejected or. should be returned to: HR. Signature: Date: All completed applications. The closing date is: 18 July 2013.

Enter text by clicking in the appropriate box. we will invite you to an interview/assessment workshop and we will ask you to state any special arrangements we should make on account of disability. NOTES ON SELECTION PROCEDURE BHC is an equal opportunities employer and appoints on merit by open competition. identity and the right to work in Kenya. The text boxes are expandable but please do not exceed the word count where it is specified.NOTES ON HOW TO COMPLETE THE APPLICATION FORM Please complete the application form electronically. we will ask you to provide proof of qualifications. The short listing process has two stages: Stage 1 – initial sift to ensure that you meet the employment criteria. based on your qualifications and experience. security clearance and confirm details of referees who we will contact for references. person specification and competence requirements. If short listed. Career History . complete a medical clearance. We are happy to receive applications electronically to the e-mail address given in the advert. Stage 2 – your capability of doing the advertised job. . Education and Professional Qualifications – We are primarily interested in the highest educational level you have achieved.list achievements rather than tasks or responsibilities. An offer of appointment is dependent on our receiving satisfactory references. If you are provisionally selected. will be considered. which is the language in which we work. At the interview/assessment centre we will ask you to provide proof of nationality. In so doing there will be a presumption that the information you have provided is true and complete. as well as whether you have basic numeracy and literacy skills in English. medical and security clearance. We want to know what you can do that is relevant to the job you are applying for – please address the job description requirements.

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