APPLICATION FORM

(Please fill in the application form accurately) 

JOB APPLIED FOR: ………………………………………………………………

1.0 Applicants’ particulars

Surname: ………………………………………………………………

Other Names: ………………………………………………………………

Sex: 1. Male…………….. 2. Female

Date of Birth: Day ……………. Month ………………….. Year ………

Marital Status: ……………………………………………………………….

Home District: ……………………………………………………………….

Town/Sub-county: ……………………………………………………………….

Village: ……………………………………………………………….

Current Residence

District: ……………………………………………………………….

Town/sub-county: ……………………………………………………………….

Village/LCI: ……………………………………………………………….

Plot No: ……………………………………………………………….

Telephone Contact: ……………………………………………………………….

Current Designation:…………………….. ………………………………………

Current Salary: ………………………………………………………..

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1.1 Education Qualifications:

(a) If holder of degree, state:

Degree:…………………………………………………………………………

(b) If holder of Diploma or Certificate state Diploma or Certificates.

…………………………………………………………………………………..
(c) If holder of Uganda Advanced Certificate of Education state
passes………………………………………………………………………….

(d) If holder of Ordinary Level Certificate of Education state passes.

…………………………………………………………………………………
…………………………………………………………………………………
(e) State any other qualifications:

…………………………………………………………………………………
…………………………………………………………………………………

1.2 Employment Record Starting With the Most Recent.

S/NO. ORGANISATION DESIGNATION DATES
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Most recent salary (gross): .……………………………………………..

Salary/ expectations (gross): ………………………………………………

List the names of your immediate Family:

Father’s Name: …………………….………………………… Alive or Dead (Tick)

Mother’s Name:…………...…………………………… ……..Alive or Dead (Tick)

Wife/Husband’s Name, address and telephone contact:

…………………………………………………………………………………………

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…………………………………………………………………………………………

1.3 Referees:

Name:……………………………………………………………………………….

Designation:……………………………………………………………………….

Postal Address:…………………………………………………………………….

Tel No……………………………………………………………………………….

Name:……………………………………………………………………………….

Designation:………………………………………………………………………..

Postal Address:…………………………………………..…………………………

Tel No……………………………………………………………………………….

……………………………….. …………………………………
Signature Date