Woolworths Jobs Application Form – Fill Out and Use This PDF

application form external

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	Section 1: Important details. Please complete (Block Letters)
Date:	Position applied for:
Vacancy requisition number:	Woolworths store applied at:

Which other Woolworths store(s) could you work in ?:

Section 2: Personal Details

Title: Mr

Mrs

Ms

Other:

First Names:

Surname:

Preferred Name:

Date of Birth:

Do you have a valid South African bar coded ID? Yes

No

ID / Permanent Residence Number:

Work Permit Number:

Nationality:

Home Address:

City:

Postal Code:

Province:

Home Telephone:

Work Telephone:

Cell Number:

Is this your personal number? Yes

No

If no, please provide the name of the contact:

E-mail:

When is the best time to contact you? Ofice hours

After hours

Other

(please specify time)

Do you have a valid driver’s licence?

Yes

No

In accordance with Woolworths employment equity approach, preference will be given to candidates from designated groups.

Please provide the following details:

Note: A certiied copy of your Identity Document must be attached to your application form.

Should you fail to complete any of the required information, this application form may be viewed as invalid for

the purpose of the application process.

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Section 3: Education and Training

Please provide details of any qualiications obtained, or courses attended, to support your application.

Name of Institution		Date		Name of qualiication
	From		Until

Section 4: Referral

How did you ind out about this job?

Were you referred to Woolworths? Yes

No

If yes, by whom?

Are you related to anyone who is employed by Woolworths? Yes

No

If yes, please indicate their Store / Department / Position:

Have you applied to Woolworths before? Yes

No

Section 5: Employment History

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Section 6: Operational Requirements

Hours of availability .You would be required to work lexible hours, be available on weekends and sometimes until late at night.

Any comments?

Transport: Are you able to travel between stores within your region when operationally required?

SECTION 7:CONTACTABLE REFERENCES (NOT RELATIVES)

Please provide the following details for two individuals we can contact to obtain a reference:

1. Name and Surname:
Position / Job Title:									Company:
Relation to Applicant:
Home Telephone:								Work Telephone:
Cell Number:						Email:
2. Name and Surname:
Position / Job Title:									Company:
Relation to Applicant:
Home Telephone:								Work Telephone:
Cell Number:						Email:

Section 8: Conditions of Employment

What is your notice period?

When can you start work?

Minimum acceptable salary package :		/month		/year

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Section 9:Applicant Permission and Indemnity

I						(Full name, surname)
Maiden Name:			Date of Birth:	/		/

ID number:

Address:

I hereby authorise Woolworths (Pty) Ltd. or the duly authorised agent, namely Lexisnexis Risk Management, to make my name, surname and identity number and / or ingerprints available to the South African Police Services, and the following Tertiary Education Institutions.

I furthermore authorise Woolworths (Pty) Ltd. or Lexisnexis Risk Management to conduct all background checks including but not limited to credit bureau searches, driver’s licence, employment history, and any other relevant checks in the pre- or post-employment vetting process and where necessary to request the South African Police Services and / or Tertiary Education Institutions to furnish personal information regarding my criminal background, criminal history, previous convictions and / or any other relevant information such as is usually furnished by the Criminal Record Centre of the South African Police Service, and or Tertiary Education Institutions in this regard, to the duly authorised agent.

I furthermore unconditionally indemnify the South African Police Service, relevant Tertiary Education Institutions and all its members, employees as well as the Government of the Republic of South Africa against any liability which results or may result from furnishing information in this regard.

I understand that it is a condition of the South African Police Service and relevant Tertiary Education Institutions, in disclosing the required information that:

(a)the information is furnished solely for the purpose of my proposed employment; and

(b)Woolworths (Pty) Ltd. / the duly authorised agent is responsible for verifying the accuracy, in every respect, of the information furnished by the South Africa Police Service.

Signed at

(place) this

day of

(month)

(year)

Signature of the applicant

As the enquiring agent of the company, I hereby state that I understand the provisions of the National Credit Act (34 of 2005), section 70(2)(g), and the Regulations made in terms of the Act, section 18(4) and (5).

Woolworths signatory:

Lexisnexis Risk Management USERNAME:

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Section 10: Disclosure, Declaration & Consent

A. DISCLOSURE OF INFORMATION

Are there any other material facts, circumstances or information, which you believe might adversely impact upon your possible

placement with the Company, that have not been conveyed to the Company? Yes		No

If the answer to the above is “Yes”, you may be required to disclose, in con dence, any details to the Human Resources department / interviewer.

B. DECLARATION

The applicant declares that:

1.1You never were and still are not a party to, or threatened by, litigation for reasons that may relate to your capacity and / or suitability and / or competence to meet the job requirements or for reasons of any material nature.

1.2You have never been found guilty of a common law offence or a statutory offence for reasons that may relate to your capacity to meet the job require- ments or for any reasons of a material nature, other than that which had been placed on record at the time of the formal application for employment.

1.3Your services have never been terminated by way of dismissal on the basis where the underlying reason for such termination was dishonesty or any breach of trust that may have arisen between any previous employer and yourself.

I hereby declare that all particulars and answers in the application, items 1- 9 inclusive, are true and that no applicable facts have been withheld. I agree that this application and declaration shall be the basis of any contract that may be entered into between the company and myself and that the withholding of any mate- rial information or failure to answer the questions honestly will constitute a breach of contract. Such a breach may result in the termination of my employment.

C. CONSENT:

I hereby consent to the company making credit and other reference checks (including, but not limited to any checks that may be required to determine the cor- rectness or otherwise of any response that I have provided in the application).

Surname:

First Name:

Signature:Date:

Please note that the fax dial code for all regions is (021) as our server is based at our Head Ofice in Cape Town.

Please fax or e-mail your completed application form to the following addresses depending on which region you wish to work in:

Kwazulu-Natal			Gauteng Central, Free State & Vaal Region
Fax:	021 4079873		Fax:	021 4079872
E-mail: recruitment3@woolworths.co.za			E-mail: recruitment1@woolworths.co.za
Eastern Cape			Gauteng North East
Fax:	021 4079870		Fax:	021 4079875
E-mail: recruitmentEC@woolworths.co.za			E-mail: recruitment2@woolworths.co.za

Please fax or e-mail your completed application form to the following addresses depending on which stores you wish to apply for in the Western Cape:

Management Vacancies		New Store Openings		Westgate Mall,V&A,Tableview, Constantia,
				Caversham, Greenpoint, Meadowridge,
				Milner Road
Fax:	021 4079885	Fax:	021 4079886	Fax:	021 4079944
E-mail: recruitment4@woolworths.co.za		E-mail: recruitment4projects@woolworths.co.za		E-mail: recruitmentwc01@woolworths.co.za
Cavendish, Hout Bay, Longbeach Mall,		Canal Walk, Kenilworth, Pinelands,		Somerset West, Somerset Mall, Parow,
Maynard Mall, Belvedere Road, Dean		Promenade, Gardens, Grassy Park, Hermanus		Parklands,Waterstone,Westcoast,
Street, Fish Hoek, Kloof Street				Stellenbosch, Stellenbosch Square
Fax:	021 4079945	Fax:	021 4079946	Fax:	021 4079947
E-mail: recruitmentwc02@woolworths.co.za		E-mail: recruitmentwc03@woolworths.co.za		E-mail: recruitmentwc04@woolworths.co.za
Cape Gate, Paarl, Paarl Mall, Big Bay,		Brackenfell, N1 City,Willowbridge,		Blue Route, Piazza St. John,Vangate,
Cobblewalk, Colloseum, Zevenwacht,		Tygervalley, Durbanville, Glengarry,		Adderley Street, Old Bakery, Sea Point,
Soneike		Paddocks, Panorama		Steenberg, De Luz
Fax:	021 4079948	Fax:	021 4079949	Fax:	021 4079950
E-mail: recruitmentwc05@woolworths.co.za		E-mail: recruitmentwc06@woolworths.co.za		E-mail: recruitmentwc07@woolworths.co.za

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