Personal Information
YesNo
Education
HIGH SCHOOL ATTENDED
Qualification achieved
Year
TERTIARY INSTITUTION ATTENDED
Diploma/Degree/Certificate attained
Year completed
If not completed, why?
COURSES
(List courses attended, relevant to this job application, one per line)
PRESENT and PREVIOUS EMPLOYMENT DETAILS
((listing present/most recent employment. It is important that all previous employment is included)
Education
Do you have a record of serious or recurring illness which shall prohibit you from performing lawful and/or reasonable work functions in a book retail environment
YesNo
Have you consulted a doctor, attended hospital or ever received any treatment for back problems, which may prohibit you from performing lawful and/or reasonable work functions in a book retail environment
YesNo
Have you ever suffered an occupational injury?
YesNo
Are you a smoker?
YesNo
Are you free of any form of addiction to alcohol or to any type of habit-forming drug, or any substance having a narcotic producing effect, socially or otherwise
YesNo
Should the position applied for, so require, do you consent to undergo a medical examination by a registered Medical Practitioner. Such test shall be for the purpose of assessing your current physical and mental ability, to perform the tasks required in the position applied for
YesNo
EMPLOYMENT EQUITY
Bargain Books is a designated employment equity company and in an effort to comply with the company’s five year employment equity plan, please complete the section below
Race
Gender
Disability
YesNo
EMPLOYMENT DESIRED
Position applied for?
Specify hours for each day of the week
Full TimePart TimeSeasonal
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Location
(please attach copy of latest payslip)
Current Salary
Period of notice required to present employer
PSYCHOMETRIC/ BASIC TRAITS INVENTORY TESTS
As part of this application for possible employment at Bargain Books, more specifically for management positions, do you consent to undergoing a psychometric test and/ or a Basic Traits Inventory test. Such tests shall be administered by a qualified psychometrist.
YesNo
PRE-EMPLOYMENT INTEGRITY AND/ OR TRUTH VERIFICATION TEST
As part of this application for possible employment at Bargain Books, do you consent to undergoing a preemployment integrity test (polygraph test) and/ or truth verification test (voice stress polygraph), conducted by a qualified Psycho physiologist and/ or voice stress examiner. The result of such examination is confidential and shall remain the property of Bargain Books.
YesNo
It is important to note that this test is used to test integrity and if you have been dishonest on this application form, or if you have benefitted from the theft of monies or goods in the past, deception shall be indicated and you shall not be considered for employment by Bargain Books.
DECLARATION
“I certify that the foregoing is a full list of all former employers. I agree that Bargain Books and its servants and agents are at liberty to contact all or any such former employers for references about me. I accept that communications between Bargain Books and my former employers and replies from such employers are privileged and will not be disclosed to me under any circumstances. I declare that the above information is completed and correct. I understand that deliberate omissions or false information may lead to termination of any employment undertaken”
SIGNED
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DATE