FORM HPA-1

SEYCHELLES ISLANDS FOUNDATION - EMPLOYMENT APPLICATION FORM

1. POST APPLIED FOR

Title:
Organisation:

Code:

2. PERSONAL INFORMATION

National Identity Number:

Surname:
(Dr/Mr/Ms)

Surname at Birth

First Names:

Nationality:
Sex:
Male:

Single:

Country of Birth:

Initials:

Date of Birth:

Postal Address:

Home
Telephone
Number:

Female:

Married:

3. EDUCATION AND TRAINING RECORD (*)

Insert the three highest qualification/level of education completed
Level/Course: _________________________________________

Course Code: -------------------------------------------------------

Certificate Obtained: ______________________________________________________________________________________

Subjects: ________________________________________________________________________________________________
Institute:
Name: _________________________________________________________________
Address: ________________________________________________________________

Date Entered:

Qual. Code:

-----/------/---Date left:

------ -----------Equivalence Ref.

-----/-----/-----Level/Course: _________________________________________

Course Code: -------------------------------------------------------

Certificate Obtained: ______________________________________________________________________________________

Subjects: ________________________________________________________________________________________________
Institute:
Name: _________________________________________________________________
Address: ________________________________________________________________

Date Entered:

Qual. Code:

-----/------/---Date left:

------ -----------Equivalence Ref.

-----/-----/-----Level/Course: _________________________________________

Course Code: -------------------------------------------------------

Certificate Obtained: ______________________________________________________________________________________

Subjects: ________________________________________________________________________________________________

Page 1

Institute:
Name: _________________________________________________________________
Address: ________________________________________________________________

Date Entered:

Qual. Code:

-----/------/---Date left:

------ -----------Equivalence Ref.

-----/-----/-----GOVERNMENT OF SEYCHELLES EMPLOYMENT APPLICATION FORM

Page 2

4. LANGUAGES:
Language:

Level and Qualifications (if any)

Code:

1. Kreol
2. English
3. French
4.
5.
5. DRIVING LICENCE (S) (State Types which you possess:)

------------

-------------

------------------

6. EMPLOYMENT HISTORY

Employer: Name: ________________________________________________________________________________________

Address: ________________________________________________________________________________________________
Position Occupied: _________________________________________________________

Gross Salary/year:

From: -------/------/---------

SR: __________________

To: ----------/----------/-----------

Reason for Leaving: ______________________________________________________________________________________

Employer: Name: ________________________________________________________________________________________

Address: ________________________________________________________________________________________________
Position Occupied: _________________________________________________________

Gross Salary/year:

From: -------/------/---------

SR: __________________

To: ----------/----------/-----------

Reason for Leaving: ______________________________________________________________________________________

Employer: Name: ________________________________________________________________________________________

Address: ________________________________________________________________________________________________
Position Occupied: _________________________________________________________

Gross Salary/year:

From: -------/------/---------

SR: __________________

To: ----------/----------/-----------

Reason for Leaving: ______________________________________________________________________________________

Employer: Name: ________________________________________________________________________________________

Address: ________________________________________________________________________________________________
Position Occupied: _________________________________________________________

Gross Salary/year:

From: -------/------/---------

To: ----------/----------/-----------

SR: __________________

Reason for Leaving: ______________________________________________________________________________________

On what date would you be available to take up employment?

------------/------------/----------

GOVERNMENT OF SEYCHELLES EMPLOYMENT APPLICATION FORM

Page 3

7. DESCRIPTION OF CAREER (Please give a concise account of relevant experience and reasons for applying for this post.
Use additional sheets if necessary) (*)

8. REFERENCES (Give Details of two persons not relatives known for two years)
Name:
Address:

Occupation:
May we contact (a ) Your present employer? _________

( b ) Your past employer? __________

9. OTHER RELEVANT PARTICULARS (Describe any special interests and hobbies) ( * )

10. NEXT OF KIN (Please specify as applicable i.e., Mother, Guardian, Spouse etc..)

National Identity Number:

Surname:

First Names:
Telephone Number:
Address:___________________________________________________________________________________________________________

GOVERNMENT OF SEYCHELLES EMPLOYMENT APPLICATION FORM

Page 4

11. FAMILY (*)

Spouse: National Identity Number

Surname:

Surname at Birth (If Applicable):

First Names:

National identity
Number:

Child 2:

Child 1:

Surname:
First Names:
Date of Birth:

School
Attended:
National identity
Number:

--------/----------/--------------

-----------/---------/-----------

Child 3:

Child 4:

--------/----------/--------------

-----------/---------/-----------

Surname:
First Names:
Date of Birth:

School
Attended:
12. INTEREST IN PRIVATE BUSINESS (Give details) (*)

13. DECLARATION (To be completed by applicant)

The Facts set forth in this application for employment are true and complete.

SIGNATURE:

14. ENDORSEMENT OF PRESENT EMPLOYER

DATE:________/______/_______

(If Applicable) (*)

DESIGNATION

SIGNATURE:.
If for any reason you should not wish to endorse this application or if you should wish to comment, please continue under separate cover.
(*) Please continue on additional sheet if necessary