Name:_____________________________________________________

Personal Information and Job Interview SheetDO NOT LEAVE ANY AREAS BLANK OR YOUR APPLICATION WILL NOT BE CONSIDERED

Your Name:

Position Applied:Referred By:

Relation to Referrer:Religion: Sect : e.g. Catholic, SDA, Jehovah. Sunni, Shia, HinduFathers Name: Fathers place of employment:

Mothers Name :Mothers Place of Employment:Your I.D No:

Your Date of Birth:

Driving license no:

Expiry date:

Driving Since:

(attach a copy)NSSF No:

NHIF No:

PIN Number

Tel Office:

Email address:

Tel Home:

Tel Mobile:

Next of Kin:

Place employed (next of kin):

Telephone No of Next of KIN

Your marital status:

No: of ChildrenSocial Networking

Facebook user name:

Twitter user name:

MSN Live user name:

Yahoo user name:

Address details

Tel Hse:____________________________Tel Mobile______________________

(Certificate scanned copy of your Certifications in Sage or Otherwise attach them)

Are you still studying or intending to study further?

Personal References:

Name:

Place of Employment:

DesignationHow related

1.

23Have you committed any Police Offences: (y/n) Provide Details__________________________ Have you any legal matters pending : (y/n)

Provide Details _________________________Have you any labor legal matters pending : (y/n) Provide details _________________ ________Do you have a CID Cert. of Good Conduct (Y/N) (attach a copy)Are you a member of any union Y/N

Provide Details__________________________Current/Last Emolument Information: (you may be called upon to evidence this via a payslip)Salary Before Taxes you received

__________________________

Allowances amount You Received

__________________________

Perks Amount you Received

__________________________

Tax You Paid

__________________________

BenefitsAmount You Receive(d)

__________________________

Insurance benefits and Value you receive_________________________Salary After taxes and deductions

_________________________If you wish to declare your preferred remuneration, you may declare it belowSalary After Taxes You expect___________________ (excluding allowances/benefits/extras) OR

Salary Before Taxes you Expect:___________________ (excluding allowances/benefits/extras)Allowances value you expect__________________________ Allowance Type:______________House Allowance you expect__________________________

Perks value you expect

__________________________ Perks type:__________________Benefits value you expect

__________________________ Benefits Type _______________Insurance benefits you expect_________________________ Insurance Type:_______________What are you capable of performing without any supervision or training?

Are you insured in any way?

Are you a Member of any SACCO/CLUB/ASSOCIATION (if so, provide details)

Any Other Information you wish to declare: (personal/religious/social/professional)

Personal and employment InformationWhy did you wish to leave your current employment? Please give reasons otermination/resignation/detachmentWhy did you leave your last employment or were you terminated? Please give reasons of termination/resignation/detachment

What do you think you will gain in your new employment and what benefit will it give you?

Are you of sound and good health? Do you suffer from any long term or recurring illness?

Did you give your last employer a Termination notice period (Y/N) If yes, how many days?

2 References from your Last employer(name, designation, tel no)

2 professional references from previous employers (name, designation, tel no)

2 other references (non-family) in Kenya (name, designation, tel no)

On your last employment, who were you reporting to and their telephone no. contacts?

(name, designation, tel no)

Have you worked with targets? If so, what was your last target amount and what %age did you achieve

Professional Information:

What is the ideal job title for a person with your skills and what role do you prefer to have within your new employment

Give us Reasons for choosing your current career path

How do you rate your accounting knowledge(very poor, poor, average, good, very good).

Is there any professional certification backing this knowledge?

On the job?

Have you worked in a support desk environment. If so, give a brief of the experience undertaken?

Have you worked in an administrative environment. If so, give a brief of the experience undertaken?

Have you worked in an accounts departments. If so, give a brief of the experience undertaken?

Have you worked in a Sales and marketing department. If so, give a brief of the experience undertaken?

On a rating BETWEEN 1 to 10 (1 being Extremely poor, and 10 being Excellent), how do you rate yourself in:

1. Social

2. Mental

3. Family

4. Wealth

5. Knowledge base

6. Friends

7. Educational

8. Health

9. Management

10. Professional

How many hours per week do you work?

What are your lifetime goals?

What/where would you like to be in 5 years from now?

What/where would you like to be in 3 years from now?

What is your most important current ambition?

What are you 3 most important and most pressing objectives?

Why Should you be considered for this Opportunity?

Do you have letters of commendation from your past employer(s)?

If not, kindly specify why you dont have a letter of commendation.

if yes, please scan and send them with your application.

Any Other Information you wish to/should declare about yourself?Are there any specific conditions that your new employer must meet?

Attach photo here

ID Card Copy side B

ID Card Copy side A

P.O.Box

City

Box Code/Post Code

Name of Owner of Post Box

Flat/Hse No/Block No

Estate/Plot No

Street/Road/Lane

Town/City/Village

Residential Status (Tenant /Owner/ Roommate/Living In/ Guest/ Owner/Living w Relative)

Education:

School/institutionWhich Years attended Qualification/Result

CourseInstitutionWhen (DD/MM/YYYY)

Past employment Information:

Employer NameDuration worked (dd/mm/yy to dd/mm/yy)Designation