South Sudan NGO Forum Secretariat
Application Form
Applicants are asked to complete this form and return it to the Human Resources & Admin Manager, Tearfund south Sudan Programme TearFund
Office, Juba.
Please type or print your answers clearly in black ink.
(JOB APPLIED FOR:_____________________________________________________)
1)           PERSONAL RECORD
1.1          Name in full
1.2          Title            Revd                    Dr                       Mr                     Mrs                      Miss
1.3          Marital status
1.4          Date of birth                                                                 Age
1.5          Place of birth                                                                           Nationality
1.6          Home (physical address):
Box no:
1.7          Telephone: Home                                                                          Work
1.8          Email
1.9          Contact address and telephone if different:
Telephone:
2.           AVAILABILITY
2.1          Present occupation/ profession. If unemployed, please state previous occupation.
2.2          Does your employer know of your application?           Yes        No
What was their response?
2.3          If selected, what period of notice would be required before you could be available?
2.4          If selected, are there any limitations to your availability?
3.           SKILL AND VOCATIONAL RECORD
Full education and employment record should be included on your enclosed cv.
3.1          List all professional, vocational and other training courses attended:
Dates                         Place                                Course                             Qualification (if any)
3.2          List all professional experience relevant to this role
(Dates of employment, employer, occupation / role, location and reason for leaving)
Dates                         Place                  Organisation                          Capacity   Reason for leaving
3.3          Do you speak any other languages? Please tick level of proficiency:
Language     ENGLISH                    Fluent        Conversational           Basic
Language                                              Fluent        Conversational         Basic
Language                                              Fluent        Conversational         Basic
Language                                              Fluent        Conversational         Basic
3.4          Do you hold a current Driving Licence?                 Yes        No
If yes, state Classes held:
3.5          Do you have a passport?                                Yes        No
If yes, what is the expiry date?
                                                                                       1
3.6            Have you had previous cross-cultural experience? Yes                 No
If yes, please expand on your experience
3.7            Have you previously worked for Tearfund or the NGO Secretariat?
Dates                       Place                                      Capacity
3.9            How did you hear of the South Sudan NGO Forum?
3.10           List any other skills or interests (e.g. handicrafts, sport, classical music……):
4.             REFERENCES
References will be taken up before the interview where possible.
4.1            Please indicate whether or not you would like Tearfund to approach your current employers for references.                         Yes No
4.2            May Tearfund approach your referees without further reference to yourself?            Yes   No
4.4            Give the name and address of two professional referees.
One referee should be in a position to comment on any previous relevant experience:
ii)                         Name:
Contact address:
Tel No:                                                                            Email:
iii)                        Name:
Contact address:
Tel No:                                                                            Email:
5.             HEALTH
5.1            Date of last full medical examination?
5.2            By whom was this carried out?
5.3            Are you in generally good health?        Excellent      Good                       Fair                 Poor
Comments:
6.             PERSONAL BACKGROUND
Please be as open and frank about yourself as possible, using extra paper as necessary to answer some of the questions.
6.1            Briefly describe the beginning and growth of your faith
6.2            Describe how your background, training and experience equips you for this post, relating your response to the criteria on the Person Specification and Job
Description:
6.3            What do you consider to be:
a.                          Your strengths in relation to this role?
b.                          Your weaknesses in relation to this role?
6.4            Do you have any family/ personal responsibilities which would need attention if you were accepted?
6.5            Is there anything else you think the selectors ought to know in considering you for this position
7.             DECLARATION
7.1            I confirm that to the best of my knowledge all the facts set out in this application are true and complete and in making this application I understand some of
the potential physical and mental risks inherent in Humanitarian assignments:
Signed:                                                                            Date: