1. FIRST NAME:

2. SURNAME:

3. OTHER GIVEN NAMES:

4. YOUR EMAIL:

5. SEX:
MaleFemaleNon-binaryOther

6. DATE OF BIRTH:

7. ADDRESS:

8. PRIMARY CONTACT NUMBER:

9. ADDITIONAL CONTACT NUMBER:

10. MARITAL STATUS:
SingleMarriedDivorcedWidowedSeparatedCommon-Law

11. DO YOU HAVE CHILDREN?
YesNo
12. IF YOU DO HAVE CHILDREN, PLEASE STATE HOW MANY AND THEIR AGES:

13. HAVE YOU EVER BEEN ARRESTED AND OR CONVICTED OF A CRIME?
YesNo
14. IF YOU HAVE YOU EVER BEEN ARRESTED AND OR CONVICTED OF A CRIME, PLEASE STATE THE DETAILS:

15. DO YOU HAVE A VALID BANK ACCOUNT?
YesNo
16. DO YOU HAVE A VALID CERTIFICATE OF CHARACTER?
YesNo
17. NATIONAL IDENTIFICATION:
ID CARDDRIVER'S LICENSEPASSPORT
18. IDENTIFICATION NUMBER FOR ABOVE:

19. DO YOU HAVE A DRIVER'S LICENSE?
YesNo
20. STATE CLASS OF DRIVER'S LICENSE IF ANSWER TO ABOVE QUESTION WAS 'YES':

[cf7mls_step cf7mls_step-1 "Next" ""] 21. WHICH JOB SUITS YOUR QUALIFICATIONS AND EXPERIENCE (select all that apply):
Plant Maintenance TechnicianProduction AssistantQuality Control TechnicianForklift Operator (Must have valid certification)Warehouse AssistantSalesperson (On Truck)Heavy T DriverSales Assistant (On Truck)Porter (At Outlets)HSE OfficerSales RepresentativesInventory ClerkAdminstrative/Clerical

22. HIGHEST LEVEL OF EDUCATION ATTAINED:
PhDMaster's DegreeBachelor's DegreeCAPECSECCXC

23. LIST YOUR CXC/CSEC/CAPE SUBJECTS AND GRADES:


24. WHAT IS YOUR CURRENT LEVEL OF COMPUTER LITERACY?
AdvancedIntermediateBasicNot computer literate

25. WHAT COMPUTER PROGRAMS/APPLICATIONS ARE YOU FAMILIAR WITH?


26. LIST THE COMPANIES YOU HAVE WORKED FOR IN THE PAST 5 YEARS (List most recent first):


27. REASON FOR LEAVING LAST JOB:


28. ADDRESS AND PHONE NUMBER OF LAST PLACE OF EMPLOYMENT:


29. POSITION HELD:


30. DURATION OF EMPLOYMENT:


31. SUPERVISOR NAME AND CONTACT NUMBER AT LAST JOB:


32. NAME OF FIRST REFERENCE (Can not be family members):


33. PHONE NUMBER FOR FIRST REFERENCE:


34. PROFESSION OF FIRST REFERENCE:


35. NAME OF SECOND REFERENCE (Can not be family members):


36. PHONE NUMBER FOR SECOND REFERENCE:


37. PROFESSION OF SECOND REFERENCE:


[cf7mls_step cf7mls_step-2 "Back" "Next" "Step 2"]38. DO YOU HAVE ANY HEALTH CONDITIONS/IMPAIRMENTS? (Eg. Vision problems, asthma, cardiovascular issues etc.):
YesNo

39. IF YOU ANSWERED YES, PLEASE GIVE DETAILS:


40. HAVE YOU BEEN HOSPITALIZED IN THE PAST 2 YEARS?
YesNo

41. IF YOU ANSWERED YES PLEASE GIVE DETAILS:


42. ARE YOU CURRENTLY ON ANY PRESCRIPTION MEDICATION?
YesNo

43. IF YOU ANSWERED YES TO #42 PLEASE STATE WHAT MEDICATIONS YOU ARE ON:


44. HAVE YOU BEEN VACCINATED AGAINST COVID-19?
YES - FIRST SHOTYES - BOTH SHOTSYES - BOTH SHOTS AND BOOSTERYES - ONE SHOT REQUIRED (Johnson & Johnson)NO I HAVE NOT BEEN VACCINATED AGAINST COVID-19

45. HAVE YOU CONTRACTED COVID-19 WITHIN THE PAST 6 MONTHS?
YesNo
46. DO YOU SMOKE?
Yes only CigarettesYes Cigarettes and MarijuanaYes OtherNo

47. DO YOU DRINK ALCOHOL?
YesNoOccasionally

48. ARE YOU WILLING TO BE DRUG TESTED PRIOR TO EMPLOYMENT IF REQUESTED?
YesNo

[cf7mls_step cf7mls_step-3 "Back" "Next" "Step 3"]DECLARATION OF ACCURACY
I declare that the information given in this application is accurate. I acknowledge that providing inaccurate or misleading information on this form may result in my application being rejected and in me being blacklisted for employment with Premium Products Ltd and it's subsidiaries.
49. I AGREE WITH, ACCEPT AND ABIDE BY THE ABOVE DECLARATION OF ACCURACY:
YesNo

50. PLEASE UPLOAD ALL SUPPORTING DOCUMENTS:
RESUME (Size Limit 5MB)

PASSPORT SIZED PICTURE (Size Limit 5MB)

ID (Size Limit 5MB)

CERTIFICATES (Size Limit 5MB)

VACCINATION CARD (Size Limit 2MB)

CERTIFICATE OF CHARACTER (front and back) (Size Limit 2MB)