✅ EXAMPLE: Z83 APPLICATION FORM (Filled In)
Applying for: Administrative Officer – Department of Health
Reference Number: DOH/25/2025
Closing Date: 30 June 2025
Section A: The Advertised Post
Position for which you are applying (as advertised):
Administrative Officer
Department where the position was advertised:
National Department of Health
Reference number (as stated in the advert):
DOH/25/2025
If you are offered the position, when can you start OR how much notice must you serve with your current employer?
Immediately / One week’s notice
Preferred language for correspondence:
English
Do you have a disability?
No
Section B: Personal Information
Surname:
Mokoena
First names:
Thabo Emmanuel
Date of birth:
15 March 1992
ID number:
920315 5320 089
Race:
African
Gender:
Male
Do you have a valid driver’s licence?
Yes
Code: B
Are you a South African citizen?
Yes
If no, what is your nationality?
N/A
Are you a permanent resident?
N/A
If you are a professional or registered with a professional body, provide the name of the body and your registration number:
N/A
Section C: Contact Details
Preferred method of correspondence:
Email
Contact number (cellphone):
072 456 7890
Email address:
thabo.mokoena@email.com
Postal address:
P.O. Box 12345
Pretoria
0001
Section D: Language Proficiency
| Language | Speak | Read | Write |
|---|---|---|---|
| English | Yes | Yes | Yes |
| isiZulu | Yes | Yes | Yes |
| Sesotho | Yes | Yes | No |
Section E: Qualifications
| Name of School / Institution | Qualification Obtained | Year Obtained |
|---|---|---|
| Tshwane South College | National Diploma: Public Management | 2014 |
| UNISA | BAdmin Degree (In Progress) | N/A |
Section F: Work Experience
Employer: Department of Social Development
Position Held: Admin Clerk
Period: Jan 2019 – Present
Duties (short summary):
Filing, record-keeping, data entry, scheduling meetings, compiling reports.
Reason for leaving:
Seeking career growth and advancement.
Section G: References
| Name | Relationship | Contact Number |
|---|---|---|
| Mr J. Mhlongo | Supervisor | 012 345 6789 |
| Ms L. Nkosi | Manager | 011 456 7890 |
Section H: Declaration
I declare that all the information provided (including any attachments) is complete and correct to the best of my knowledge. I understand that any false information supplied could lead to my application being disqualified or my discharge if I am appointed.
Signature:
Thabo Mokoena
Date:
21 June 2025
📌 Attachments to include:
-
Certified copy of ID
-
Certified qualifications
-
Certified driver’s license
-
Updated CV
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