SEASONAL

WORKERS PROGRAM
(FRUIT PICKING)
KOROBA LAKE
KOPIAGO DISTRICT
2023 – 2027 Application Form

Personal Information

Name:

Gender:

Date of Birth: / /

Age:

Weight:

Height:

Religion:

Residential Information

Clan/Tribe:

Ward:

LLG:

District:

Province:

Current Residential:

Educational Background

Grade 10 Certificate: Name of the Institution: ________________________________

Grade 12 Certificate: Name of the Institution: ________________________________

Technical Collage: Name of the Institution: __________________________________

University: Name of the Institution: ________________________________________

Requirements
(Tick the box below if you have any of the following requirements)

Passport:

Birth Certificate:

NID:

Police Clearance:

Vaccination Card:

References:

Word Experiences

Date of Commenced: / /

Date of Ended: / /

Name of the Organization:

Years of Experiences:

Place of work:

Province:

Note: For those of you do not have any of above requirements and find it hard to provide,
you are asked to deposit K1000 to New World Consultancy Limited for help. The account
detail provided below.

Consultant fee is K500 to be deposited in the account below;

Bank South Pacific

Account Name: New World Consultancy Limited
Account Number: ………………………………………….

______________________________________
Xavier James Kubunu
Coordinator
Seasonal Workers Program (Fruit Picking)
Koroba Lake Kopiago District
Hela Province