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Application
Home
» Application
1. Vacancy Applied For
Vacancy/Post
Vacancy No:
State Corporation
2. Personal Details of the Applicant
Title
Prof
Dr
Mr
Mrs
Miss
Ms
Rev
Surname
First Names
Other Name(s)
Gender
Male
Female
Date of Birth
ID No
Pin.No
Nationality
Ethnicity
Home County
Sub County
Constituency
Postal Address
Code
Town/City
Telephone
Mobile
Email
Alternative Contact Person
Alternative Contact Person Telephone
Are you living with a disability?
Yes
No
(i) Details/Nature of Disability:
(ii) Details of Registration with the National Council for People with Disabilities (Registration No. and date
3. Applicants in the Public Service
only
Ministry/State Department/County/Other Public Institutions
Station
Personal/Employment No
Present Substantive Post
Job group/Scale/Grade
Date of Current Appointment
Upgraded post
Effective date of previous appointment
On Secondment (where applicable)
Organization
Designation
Job Group/Grade
Terms of Service
Permanent & Pensionable
Contract
Other
Please specify
4. All
other
Applicants
Current employer (where applicable)
Position held
Effective date
Gross Salary (monthly) Ksh
5. Other Personal Details
Have you ever been convicted of any criminal offence or a subject of probation order?
Yes
No
If Yes, state nature of offence, the year and duration of conviction
Have you ever been dismissed or otherwise removed from employment?
Yes
No
If Yes, State reason (s) for dismissal/removal
Effective Date
(Declaring the above information will not necessarily debar an applicant from employment in the Board. Each case will be considered on its own merit)
6. Academic Qualifications. (Starting with the Highest)
Year
University/ High School
Award/Attainment (e.g. Masters, Bachelors, Degree, KCSE)
Award/Attainment (e.g. Higher Diploma, Diploma, Certificate)
Specialization/Subject (e. g Human Resource, Engineering, Counsellin e.t.c)
Class/Grade
From
To
7. Professional/Technical Qualifications/Certifications Relevant to the post. (Starting with the Highest)
Year
Institution
Course/Programme (e.g. PhD, MSc, BA, O’Level)
Specialization/Subject (e. g Econ, Maths, Sociology e.t.c)
Class/Grade
From
To
8. Relevant Courses and Training attended lasting not less than One (1) Week.
Year
University/College/Institution
Name of Course
Details and duration
9. Current Registration/Membership to Professional Bodies
Professional Body
Membership/Registration No.
Membership type (e.g. Associate, Full etc.)
Date of Renewal
10. Employment Details - where applicable (starting with the current or most recent)
Year
Designation/ Position
Job Group/Grade/ScaleGross Monthly Salary(Ksh)
Ministry/State Department/ Institution/ Organization
From
To
11. Briefly state your current duties, responsibilities and assignments (if any)
12. Please give details of your abilities, skills and experience which you consider relevant to the position applied for. This information may include an outline of your most recent achievements and your reasons for applying for this post.
13. Referees (People who have interacted with you professionally)
Referee 1
Full Name
Occupation
Address
Post Code
City/Town
Mobile No
Email
Period for which the referee has known you
Referee 2
Full Name
Occupation
Address
Post Code
City/Town
Mobile No
Email
Period for which the referee has known you
Referee 3
Full Name
Occupation
Address
Post Code
City/Town
Mobile No
Email
Period for which the referee has known you
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