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: APPLICATION FOR EMPLOYMENT FORM: Position Applied For First Names : : Tel (H) Email Postal Address Race : Read : Fax : Physical Address : Alternative No. : ID No.: : Cellphone : Tel (W) Language : : Surname Gender Write Speak : Proficiency 1. Have you ever been convicted of a criminal offence Yes No Yes No If YES give details 2. Is there any pending criminal matter being investigated against you? If YES give details 3. Have you ever been dismiss.

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