APPLICATION COVER SHEET

Internal Employee

New Applicant

EMAIL :

NAME OF APPLICANT :

POSITION APPLIED FOR:

POSITION NO:

GRADE:

In your own words, please explain how you satisfy each of the position and person specifications contained in the job description for the position:

EDUCATIONAL QUALIFICATIONS :

Preferred Qualification :

Other Qualification :

EXPERIENCE :

Preferred Job Experience :

SKILLS :

Knowledge :

Skills :

I hereby declare that the information provided including copies of certificates and other documents are accurate and solely mine.

Signature:

Date:

Please attach this form to the front of your completed Public Service Application (Form SR 3-2)

PUBLIC SERVICE OF PAPUA NEW GUINEA APPLICATION FOR EMPLOYMENT

Form RS.3.2

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RECENT PHOTOGRAPH

PLEASE COMPLETE IN FULL IN BLOCK LETTERS USING BLACK OR BLUE INK OR IN TYPESCRIPT

POSITIONS APPLIED FOR:

POSITION NUMBER:

NAME:

SURNAME:

GIVEN NAMES:

GENDER: Male Female

NAME AT BIRTH (if different)

SURNAME:

GIVEN NAMES:

ANY OTHER NAMES USED:

DATE OF BIRTH:

PLEASE WRITE DOWN PLACE OF BIRTH DETAILS IN THE BELOW FIELDS:

DISTRICT/CITY

PROVINCE/STATE

COUNTRY

CITIZENSHIP

If naturalised Citizen, Nationality at birth:

MARITAL STATUS MARRIED SINGLE SEPARATED DIVORCED WIDOWED

If married Date of Marriage:

Spouse's Employer:

Spouse's File Number (if Govt. employed):

HAVE YOU ANY CHILDREN? Specify number below and add details

	Name	Male/Female	Date of Birth

PERMANENT ADDRESS:

TELEPHONE No:

PRESENT ADDRESS (If Different):

Until:

TELEPHONE No:

National Public Service General Orders (Fourth Edition)

GO 3/ Rev0/ 1st January 2012

2

PLACE OF RESIDENCE LAST FIVE YEARS (Other than vacation)	FULL POSTAL ADDRESS	DATES
		to
		to
		to
		to

SECONDARY EDUCATION

SCHOOL:

Name of Examination

Year Passed

SUBJECT

Result

SCHOOL:

Name of Examination

Year Passed

SUBJECT

Result

TERTIARY EDUCATION

UNIVERSITY, COLLEGE
COURSE
DURATION, Please follow this pattern (09-01-2012 TO 09-01-2015)	To
QUALIFICATION OBTAINED

Give details of ALL branches of subject taken

YEAR 1

SUBJECT

RESULT

YEAR 2

SUBJECT

RESULT

YEAR 3

SUBJECT

RESULT

YEAR 4

SUBJECT

RESULT

National Public Service General Orders (Fourth Edition)

GO 3/ Rev0/ 1st January 2012

3

ADDITIONAL QUALIFICATIONS, FURTHER STUDY, RESEARCH
PUBLICATIONS
PRIZES, SCHOLARSHIPS, etc
MEMBERSHIP OF LEARNED SOCIETIES OR INSTITUTES (Give date of admission and level of membership)

EMPLOYMENT RECORD

PRESENT POSITION OR LATEST POSITION HELD
Name and Address of Employer
Title of Job
Period
Present Salary
If on Salary Range, please state range

DESCRIPTION OF WORK, INCLUDING SUPERVISORY DUTIES

PREVIOUS POSITION HELD - in reversed consecutive order
Name and Address of Employer
Title of Job
Period	to

Name and Address of Employer
Title of Job
Period	to

Name and Address of Employer
Title of Job
Period	to

Name and Address of Employer
Title of Job
Period	to

CIVIC ACTIVITIES, CLUBS/SOCIETIES

INTERESTS, SPORTS/RECREATION

CLOSE RELATIVES	FULL NAME (including maiden name)	DATE OF BIRTH	ADDRESS
	FATHER
	MOTHER
	SPOUSE
	SERVICE IN THE ARMED FORCES
	BRANCH OF SERVICE		RANK
DATE OF ENLISTMENT		DATE DISCHARGED
REASON
Have you been convicted of an offence?
YES (Give details if YES) NO
PREVIOUS APPLICATIONS FOR POSITIONS IN PAPUA NEW GUINEA	Position	Authority	Date
PREVIOUS APPLICATIONS FOR POSITIONS IN PAPUA NEW GUINEA
REFERENCES: Name four persons who can comment on your academic work or on your professional experience. Before nominating them you should have their permission to give their names. We will wish to approach referees before interview. If , however, an approach to any particular referee is inconvenient at present, please indicate:* NCES
Name and Position	Relevance	Address	Tel. No.

National Public Service General Orders (Fourth Edition)

GO 3/ Rev0/ 1st January 2012

4

If applying for an advertised vacancy, journal in which advertisement seen:

NOTE: THE DISCOVERY OF ANY INCORRECT OR MISLEADING STATEMENT OR DELIBERATE OMISSION COULD RENDER ANY EMPLOYMENT OR CONTRACTUAL AGREEMENT VOID WITHOUT COMPENSATION OR REPATRIATION

I hereby declare that the information provided including copies of certificates and other documents are accurate and solely mine.

SIGNATURE:

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