Download - GRADUATE TRAINEE 2014 - APPLICATION FORM.doc

Kenya Revenue Authority is an Equal Opportunity EmployerKenya Revenue Authority is an Equal Opportunity Employer

APPLICATION FORM FOR GRADUATE TRAINEE POSITIONS APPLICATION FORM FOR GRADUATE TRAINEE POSITIONS

PART A: PERSONAL PARTICULARSPART A: PERSONAL PARTICULARS

(Please fill in BLOCK/CAPITAL letters)(Please fill in BLOCK/CAPITAL letters)

1.1. Surname: _________________ Other Names: _____________________Surname: _________________ Other Names: _____________________

2.2. Gender: ____________________________Gender: ____________________________

3.3. (i) (i) Ethnic Group: ____________________________Ethnic Group: ____________________________

(ii)(ii) Ethnic Sub-Group: (Ethnic Sub-Group: (where applicablewhere applicable): ____________________): ____________________

4.4. Religion: __________________________Religion: __________________________

5.5. (i) County of Birth: ____________________________(i) County of Birth: ____________________________

(ii) Constituency: ____________________________(ii) Constituency: ____________________________

(iii) Ward : ____________________________(iii) Ward : ____________________________

(iv) Location: ____________________________(iv) Location: ____________________________

(v) Sub-Location : ____________________________(v) Sub-Location : ____________________________

6. Date of Birth: (dd/mm/yyyy): ____________________________6. Date of Birth: (dd/mm/yyyy): ____________________________

7. Nationality: ____________________________7. Nationality: ____________________________

8.8. National ID No: ____________________________National ID No: ____________________________

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PART B:PART B: PERSONAL CONTACT DETAILSPERSONAL CONTACT DETAILS

9.9. Postal Address: _____________Code: ______ Town________________Postal Address: _____________Code: ______ Town________________

10.10. Telephone Contacts: Cellphone No: ________________Telephone Contacts: Cellphone No: ________________

Alternative Contact No: ________________Alternative Contact No: ________________

11.11. Email Address: ____________________________Email Address: ____________________________

PART C: ACADEMIC AND PROFESSIONAL QUALIFICATIONS:PART C: ACADEMIC AND PROFESSIONAL QUALIFICATIONS:

(1)(1) State Schools and Colleges attended and indicate any Educational/ State Schools and Colleges attended and indicate any Educational/ Professional/ Technical qualifications obtained. Professional/ Technical qualifications obtained.

a. ACADEMIC QUALIFICATIONS (a. ACADEMIC QUALIFICATIONS (start with the Degree Qualification start with the Degree Qualification followed by KCSE or equivalent qualification)followed by KCSE or equivalent qualification) AND OTHER AND OTHER QUALIFICATIONS AS APPLICABLEQUALIFICATIONS AS APPLICABLE

Name of the Name of the Institution Institution (University/ (University/ School)School)

FromFrom(Year)(Year)

ToTo(Year)(Year)

Qualifications Qualifications ObtainedObtainede.ge.g BCom - BCom -

Procurement,Procurement, BSc.-BSc.-

Mathematics, IT Mathematics, IT etc.etc.

KCSE KCSE

Class/Level/Class/Level/Grade attained Grade attained e.g.e.g. 11stst Class, Class,

HonorsHonors A – A –

etc.etc.

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bb. . PROFESSIONAL/TECHNICAL QUALIFICATIONSPROFESSIONAL/TECHNICAL QUALIFICATIONS

Name of the Name of the Institution Institution (University/C(University/College)ollege)

FromFrom(Year)(Year)

ToTo(Year)(Year)

Qualifications Qualifications Obtained (level, and Obtained (level, and Field) e.g. Field) e.g. CPA Part II - Section CPA Part II - Section

3. 3. Higher Diploma in Higher Diploma in

Human Resources Human Resources Management Management

Certificate in Certificate in Computer Packages Computer Packages etc.etc.

Grade/Level Grade/Level e.g.e.g.

Credit,Credit, Pass etc.Pass etc.

PART D: EMPLOYMENT HISTORY (PART D: EMPLOYMENT HISTORY ( where applicablewhere applicable )) ::Give particulars of your employment history since leaving Give particulars of your employment history since leaving School/University (Start with the current position). School/University (Start with the current position). Name & full Name & full address ofaddress ofEmployer Employer

PositioPosition held n held

Brief Brief description description of duties of duties performed performed

From From (Year)(Year)

To To (Year) (Year)

ReasonsReasons forforleavingleaving

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PART E: PERSONAL DISCLOSURE PART E: PERSONAL DISCLOSURE ((Answer all the Questions by Ticking as appropriate and providing details as Answer all the Questions by Ticking as appropriate and providing details as necessarynecessary))

1.1. Have you ever been dismissed or otherwise removed from any Have you ever been dismissed or otherwise removed from any employment (employment (if applicableif applicable)?)?

YESYES

NO NO

If YES, please give details:If YES, please give details:………………………………………………………………………………………………………………………………………………………………………………………………

…………

………………………………………………………………………………………………………………………………………………………………………………………………

…………

2.2. Do you suffer from any physical impairment? Do you suffer from any physical impairment? ((Attach a copy of Disability Certificate if anyAttach a copy of Disability Certificate if any))

YES YES

NO NO If YES give details on nature of disabilityIf YES give details on nature of disability………………………………………………………………………………………………………………………………………………………………………………………………

………………

………………………………………………………………………………………………………………………………………………………………………………………………

………………

3.3. Have you ever been charged/convicted on any charge of a criminal Have you ever been charged/convicted on any charge of a criminal offence in a Court of law? offence in a Court of law?

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YES YES

NO NO

If YES, state the offence committed and sentence imposed:If YES, state the offence committed and sentence imposed:

………………………………………………………………………………………………………………………………………………………………………………………………

………………

………………………………………………………………………………………………………………………………………………………………………………………………

………………

4.4. Have you ever, with or without being convicted been made the subjectHave you ever, with or without being convicted been made the subject of a probation order? of a probation order?

YES YES

NO NO

If YES, give details:If YES, give details:………………………………………………………………………………………………………………………………………………………………………………………………

……

………………………………………………………………………………………………………………………………………………………………………………………………

……

………………………………………………………………………………………………………………………………………………………………………………………………

……

5. REFEREESREFEREES:Referee 1Referee 1 Referee 2Referee 2 Referee 3Referee 3

Full NamesFull Names

Email Email

Address Address

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Cell Phone Cell Phone

No. No.

OccupationOccupation

Period Period known to known to you (e.g. you (e.g. 2yrs)2yrs)

NOTE:NOTE:Referees indicated should be people who know you well and exclude relatives.Referees indicated should be people who know you well and exclude relatives. The period should be indicated in specific number of years/months e.g. 2 yearsThe period should be indicated in specific number of years/months e.g. 2 years or 2 months. Please avoid statements such as “since birth” or “since 1980”)or 2 months. Please avoid statements such as “since birth” or “since 1980”)

PART F: DECLARATION:PART F: DECLARATION:

I, …………………………………………………………………… hereby certify that to theI, …………………………………………………………………… hereby certify that to the

best of my knowledge, the particulars given on this form are correct.best of my knowledge, the particulars given on this form are correct.

……………………………………..…………………………………….. ………………………………….………………………………….Applicant’s SignatureApplicant’s Signature DateDate

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Download - GRADUATE TRAINEE 2014 - APPLICATION FORM.doc

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