TS.FORM 2
50m B3426/
77P/
F2
Ref
er
enceNo:
…………………………………….
.
TEACHI
NGSERVI
CE
APPLI
CATI
ONFORAPPOI
NTMENTTODI
VI
SI
ONI
I
/
I
I
IOFTHESERVI
CE
PARTI
(
t
obecompl
et
edbyal
lappl
i
cant
si
nt
r
i
pl
i
cat
e)
A. Per
sonaldet
ai
l
s(
al
l
r
el
ev
antsect
i
onst
obecompl
et
ed)
:
or
der
l
y
1. SURNAME:(
MR/
MRS/
MI
SS)
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2. CHRI
STI
ANNAMES,
i
nf
ul
l
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(
1and2t
obecompl
et
edi
nbl
ockcapi
t
al
s)
3. Dat
eofBi
r
t
h:
………………………………………………
4.Pl
aceofBi
r
t
h:
……………………………
5. Rel
i
gi
ousDenomi
nat
i
on:
………………………………
7. Chi
l
dr
en
6.Mar
i
t
al
St
at
us………………………………
Mal
e……………………………………………
Aged……………………………………y
ear
s
Femal
e………………………………………
Aged……………………………………y
ear
s
8. Nat
i
onal
i
t
y…………………………………………………
9.Passpor
t
/
NRCNo…………………………
10.Tr
i
be:
…………………………………………………………
11.Chi
ef
:
…………………………………………
12.Vi
l
l
age:
………………………………………………………
13. Di
st
r
i
ct
:
……………………………………
B. Educat
i
onandTr
ai
ni
ng:
DATES
Fr
om
WHEREEDUCATEDANDTRAI
NED
Mont
h
To
Year Mont
h
Year
STANDARDPASSED
CERTI
FI
CATE/
SOBTAI
NED
…………………………………………………………………………………………………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………………………………………………………………………………………………
……………………………………………………………
c. Pr
ev
i
ousExper
i
ence:
NAME(
S)
OF
PREVI
OUSEMPLOYER/
S
DATES
Fr
om
POSI
TI
ON/
SHELD
Mont
h
Year Mont
h
To
Year
REASONSFORLEAVI
NG
…………………………………………………………………………………………………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………………………………………………………………………………………………
……………………………………………………………
D. If
ul
l
yunder
st
and(
a) ThatunderTSRegul
at
i
on37,
Iwi
l
l
bepost
edwher
eIam neededandnotnecessar
i
l
yt
ot
hePr
ov
i
nceofmychoi
ce;
(
b) Thatasamemberoft
het
eachi
ngSer
v
i
cemyof
f
i
ci
al
namesandt
heonl
ynamest
obeusedbymewi
l
l
bet
heonesont
hi
s
f
or
m
Appl
i
cant
’
ssi
gnat
ur
e:
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e.
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*
Af
emal
eempl
oy
eewhomar
r
i
esdur
i
ngt
hecour
seofherser
v
i
ceandi
sr
eengagedwi
l
l
ofcour
set
akehermar
r
i
ednameonr
eengagement
.
PARTI
I
(
Tobecompl
et
edbyaMedi
cal
Pr
act
i
t
i
oner
)
Ihav
eexami
ned.
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andf
i
ndhi
m/
herf
i
tf
orf
ut
ur
eempl
oy
mentasa.
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Remar
ks.
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Dat
e.
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.
Si
gnat
ur
eofMedi
calPr
act
i
t
i
oner
*I
nt
hecaseofanappl
i
cantwhoi
snotcompl
et
i
ngacour
seofTeachert
r
ai
ni
ng.Thi
scer
t
i
f
i
cat
emustbecompl
et
edbef
or
e
appr
ov
alf
ort
heappoi
nt
mentoft
heappl
i
canti
ssought
.I
nt
hecaseofanappl
i
cantwhoi
sat
t
endi
ngaTeacherTr
ai
ni
ng
Col
l
ege,
t
hecer
t
i
f
i
cat
emustbecompl
et
ednotear
l
i
ert
hatsi
xmont
hsandnotl
at
ert
hanonemont
hbef
or
et
heappl
i
canti
sdue
t
ocompl
et
et
hecour
seoft
r
ai
ni
ng.
PARTI
I
I
(
Tobecompl
et
edbypr
ospect
i
v
eempl
oy
er
)
1.
3.
4.
5.
Pr
oposedappoi
nt
ment
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.2.Pr
oposedSal
ar
y
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Pr
oposeddat
eoff
i
r
stappoi
nt
ment
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.
Tof
i
l
l
v
acancy
/
newpostat
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.school
Dat
e.
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Si
gnat
ur
e.
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Agency
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PARTI
V
Theappoi
nt
mentoft
heabov
enamedt
ot
hepostof.
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.i
nDi
v
i
si
onoft
heSer
v
i
cewi
t
hi
ni
t
i
al
sal
ar
yatt
her
at
e
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perannum i
nt
hescal
e.
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i
sappr
ov
edwi
t
hef
f
ect
Fr
om .
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19.
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Theappl
i
canti
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obeappoi
nt
ed*onpr
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ar
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oy
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ur
ei
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al
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e.
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Per
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ar
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easappr
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Mi
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yofEducat
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Tr
ai
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Languagesspoken(
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orf
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orf
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Dat
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udent
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TSFor
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NTMENT
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ockedbyMi
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ar
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medempl
oy
ee.
2.Yourcommenci
ngSal
ar
yi
satt
her
at
eof.
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ay
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nt
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e.
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Andy
ouri
ncr
ement
al
dat
ei
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2. Youar
epost
edt
o.
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school
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oupNumber
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4.Youar
eex
pect
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sol
ongasy
ouar
ei
nt
heSer
v
i
ce,
t
oser
v
et
hey
out
hoft
hecount
r
yt
ot
he
Bestofy
ourabi
l
i
t
yandt
ouphol
dt
hehi
ghestst
andar
dsoft
het
eachi
ngpr
of
essi
on
5.i
fi
ti
sf
oundt
haty
ouar
eunabl
et
oper
f
or
m ef
f
i
ci
ent
l
yt
hedut
i
esofy
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ment
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ori
f
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our
sel
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not
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6.Youmaybedi
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ssedwi
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houtnot
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cei
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our
epeat
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i
ousl
ymi
sconducty
our
sel
fori
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ti
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oundt
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ci
entowi
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eness.
7.i
fy
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or
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gny
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8.Youar
el
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abl
et
oser
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ei
nanypar
toft
hecount
r
y
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9.Thepr
ov
i
si
onsoft
heZambi
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ngSer
v
i
ceRegul
at
i
onsandt
heZambi
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v
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Pensi
onsRegul
at
i
onsappl
yt
oy
ou.
10.Speci
al
Condi
t
i
onswhi
chappl
yt
oy
ourappoi
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menti
naccor
dancewi
t
ht
hepr
ov
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si
ont
o
r
egul
at
i
on4oft
heZambi
aTeachi
ngSer
v
i
ceRegul
at
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onsar
eat
t
ached.
11.Youar
eexpect
edt
opassanef
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ci
encyBarExami
nat
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onbef
or
et
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f
ai
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ur
et
opasst
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nat
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odat
ewi
l
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r
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t
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di
ngof
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ement
sandmayl
eadt
oy
ourbei
ngdi
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gedf
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om t
heSer
v
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ce.
APPLI
CABLEONLYTOTEACHERSONTEMPORARYTERMSOFSERVI
CEONLY
12.I
nt
heev
entofy
ourmar
r
i
agei
nt
er
f
er
i
ngi
nanywaywi
t
ht
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f
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ourdut
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est
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ghti
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eser
v
edt
ot
er
mi
nat
ey
ourappoi
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mentwi
t
houtnot
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13.Quar
t
er
swi
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/
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l
notbepr
ov
i
ded.
Pl
aceofengagement
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Dat
e:
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Si
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For
/
Per
manentSecr
et
ar
y
,
Mi
ni
st
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yofEducat
i
on
*
Del
et
ei
fnotappl
i
cabl
e
PARTI
I
Mar
i
t
al
St
at
us:
Mar
r
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ngl
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edWoman.
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onNo.andDat
eofBi
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Qual
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BLOCK
LETTERS
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Cer
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Col
l
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ai
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Pl
easei
nser
ti
nt
heboxbel
owanypay
ment
smadel
ocal
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Dat
eofPay
ment
Amount
K
Tot
al
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t
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Desi
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(
mustbeadul
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hor
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)
PARTI
I
I
Ihav
er
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Si
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NBTeacher
sar
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DI
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REPUBLI
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1.APPOI
NTMENTDESI
RED.(
i
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e.Pr
i
mar
y
,
Secondar
y
,
Techni
cal
,
TeacherTr
ai
ni
ng,
et
c)
Post
3.PERSONALDETAI
LS.(
Al
lr
el
ev
antsect
i
onst
obecompl
et
ed)
SURNAME MR.MRS.MI
SS.
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BLOCK
MAI
DENNAME(
Mar
r
i
edwomenandwi
dows).
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CAPI
TALS
CHRI
STI
ANNAMESi
nf
ul
l.
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ADDRESS(
a)Resi
dent
i
al.
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(
b)Post
al………………………………………………………………………………………………………………………….
(
Al
lcommuni
cat
i
onwi
l
lbesentt
ot
hi
saddr
essunl
essachangeofaddr
essi
snot
i
f
i
edi
nwr
i
t
i
ng)
Dat
eofBi
r
t
h
Agel
astBi
r
t
hday
Pl
aceofBi
r
t
h
Nat
i
onal
i
t
y
wi
dowed
Whet
herSi
ngl
e
Passpor
tNo.andpl
aceofi
ssue
Nat
i
onal
Regi
st
r
at
i
onNo.
(
Abi
r
t
hcer
t
i
f
i
cat
emustbef
ur
ni
shedi
fav
ai
l
abl
e;
i
twi
l
l
r
et
ur
ned)
Rel
i
gi
ousDenomi
nat
i
on………………………………………………………………………………………………………………………………………………………
Numberof
Sons
Agedr
espect
i
v
el
yy
ear
s
Chi
l
dr
en
Daught
er
s
Agedr
espect
i
v
el
yy
ear
s
Name
Nat
i
onal
i
t
yatBi
r
t
h
Pl
aceofBi
r
t
h
Occupat
i
on
Fat
her…………………………………………………………………………………………………………………………………………………………………………………
……………………………………………………………………………………………………………………………………………………………………………………
Mot
her…………………………………………………………………………………………………………………………………………………………………………………
……………………………………………………………………………………………………………………………………………………………………………………
*
Wi
f
e/
Husband……………………………………………………………………………………………………………………………………………………………
……………………………………………………………………………………………………………………………………………………………………………………
*
Mai
dennamemustbegi
v
eni
ncaseofMot
herandWi
f
e.I
fdead,
t
heabov
equest
i
onsshoul
dnev
er
t
hel
essbeanswer
ed.
Addr
essofFat
her(
i
fl
i
v
i
ng)
…………………………………………………………………………………………………………………………………………………
I
fansweri
s‘
Yes’
st
at
er
esi
dent
i
al
addr
essesi
nZambi
adur
i
ngt
hatper
i
od.
Dat
es
Hav
ey
our
esi
dedi
nZambi
a
Atanyt
i
medur
i
ngt
hepast
Thr
eey
ear
s!
Yes
or
No
Hav
ey
oupr
ev
i
ousl
ybeenanappl
i
cantf
or
empl
oy
menti
n……
Fr
om
YesofNo
To
Addr
ess
I
fanswert
o(
a)
,
(
b)or‘
Yes’
,
gi
v
epar
t
i
cul
ar
s
Mar
r
i
ed,
ordi
v
or
ced
(
a) Thi
scount
r
yi
nt
heTeachi
ngSer
v
i
ce‘
’
(
b) TheZambi
aCi
v
i
l
Ser
v
i
ceorZambi
a
Pol
i
ce.
.
.
.
.
. .
. .
..
..
.
(
c) Theser
v
i
ceofanyot
herGov
er
nment.
.
Knowl
edgeofLanguagesot
hert
hanEngl
i
sh
Language
Abi
l
i
t
yi
nEngl
i
sh
Fl
uency
Wr
i
t
t
en
Spoken
4. EDUCATI
ONALRECORD
(
a) SCHOOLS
Dat
es
Fr
om
Exami
nat
i
onspassed,
Cer
t
i
f
i
cat
esandany
di
st
i
nct
i
onsgai
nedi
nschool
wor
k
NameandPl
aceofSchool
To
(
b) UNI
VERSI
TY/
TEACHERTRAI
NI
NGCOLLEGE(
orot
heri
nst
i
t
ut
i
on)
Teachi
ngSubj
ect
sOf
f
er
ed
Dat
es
Fr
om
To
Uni
v
er
si
t
y
/
TeacherTr
ai
ni
ng
Subj
ect
sr
ead,
Schol
ar
shi
ps
Col
l
eges,
e.t
.c. hel
dorpr
i
zeswon
Subj
ect
s
Degr
ee,
Di
pl
omaorPr
of
essi
onalQual
i
f
i
cat
i
on
Dat
eobt
ai
ned
Atwhatl
ev
el
of
f
er
ed
(
e,
g,
Pr
i
mar
y
,
Juni
or
Secondar
y
,
‘
O’
l
ev
el
,
‘
A’
l
ev
el
)
Resul
torCl
assobt
ai
nedi
neachpar
tofcour
se
(
i
fcour
senoty
etcompl
et
ed,
gi
v
epar
t
i
cul
ar
sanddat
eoff
i
nalexami
nat
i
on)
5. PREVI
OUSTEACI
NGRECORD (
Fr
om compl
et
i
onofeducat
i
ont
opr
esentt
i
me)
Dat
es
NameandBusi
nessofEmpl
oy
er
Fr
om
To
Addr
ess
Posi
t
i
onhel
d
Reasonf
orl
eav
i
ng
Not
e–i
ti
si
mpor
t
antt
hatf
ul
l
det
ai
l
s(
i
ncl
udi
ngdat
es)ar
egi
v
enast
hi
smayaf
f
ectt
heassessmentoft
hest
ar
t
i
ngsal
ar
y
.Document
ar
ypr
oofmustbe
suppl
i
edt
osubst
ant
i
at
epr
ev
i
ousexper
i
encef
ori
tt
oqual
i
f
yf
ori
ncr
ement
al
.
Sal
ar
yi
npr
esentempl
oy
ment(
ori
nl
astempl
oy
menti
fnotpr
esentempl
oy
ed)K.
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.
perannum.
I
ft
hewhol
eofy
ourcar
eer
,
i
ncl
udi
ngeducat
i
on,
I
snotaccount
edf
orbyy
ouranswer
st
osect
i
ons
3,
4and5,
gi
v
ef
ur
t
herdet
ai
l
st
oaccountf
or
Gaps
6. HEALTH.
YesorNo
I
fansweri
s‘
No’
,
gi
v
epar
t
i
cul
ar
s
Ar
ey
oust
r
ong,
act
i
v
e,
andf
r
eef
r
om
Bodi
l
yi
nj
ur
yordef
ect
?
Hav
ey
ousuf
f
er
edf
r
om
YesorNo
1fansweri
f‘
Yes’
,
gi
v
epar
t
i
cul
ar
s
YesorNo
1fansweri
f‘
Yes’
gi
v
epar
t
i
cul
ar
s
(
a) Epi
l
epsyorf
i
t
s.
..
.
(
b) Neur
ast
heni
a
.
..
.
(
c) St
omachul
cer
s .
. .
.
(
d) I
mpedi
menti
nspeech.
.
(
e) Anyot
herser
i
ousi
l
l
ness?
Hav
ey
ouev
erl
ef
templ
oy
ment
Formedi
cal
r
easons?
7. CHARACTER.
Hav
ey
ouatanyt
i
me(
s)
Yes or No
beenCONVI
CTEDorFOUNDGUI
LTYofanyof
f
encebyaCour
tMar
t
i
al
?.
.
.
.
.
.
.
.
(
Of
f
encesdi
sposedofbysi
gnat
ur
eofan‘
Admi
ssi
onofGui
l
t
’
wi
t
houtappear
ancebef
or
eaCour
tneednot
Bement
i
oned.
)
hadasummonsorchar
geagai
nsty
oudi
smi
ssedunderanyPr
obat
i
onofOf
f
ender
sorsi
mi
l
arOr
di
nanceof
Act
?
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.
(
b)
(
c)
BeenBoundOv
erorpl
acedonPr
obat
i
onwi
t
houtconv
i
ct
i
onf
ornayof
f
ence
(
d)
Hadasummonsi
ssuedagai
nsty
ouoranychar
gebr
oughtagai
nsty
oui
nr
espectofnayof
f
encewhi
chhas
Noty
etbeendi
sposedof
?
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.
.
I
ft
heanswert
ooneormor
eoft
hesect
i
onsabov
ei
s‘
Yes’
,
par
t
i
cul
ar
sofal
l
of
f
encesmustbegi
v
en
Gi
v
ei
nBl
ockl
et
t
er
st
henamesandaddr
essesoft
wor
ef
er
eesast
ochar
act
erwhohav
egi
v
enper
mi
ssi
onf
ort
hei
rnamest
obeused.Theyshoul
dbe
r
esponsi
bl
eper
sonswhoknowy
ouwel
l
,
ei
t
heri
npr
i
v
at
el
i
f
eori
nbusi
ness,
andone,
atl
east
,
shoul
dbewel
l
acquai
nt
edwi
t
hy
oui
npr
i
v
at
el
i
f
e.The
namesofr
el
at
i
v
esmustnotbegi
v
en.
1.
Name.
.
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. 2.Name.
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Addr
ess.
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Addr
ess.
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.
Occupat
i
on.
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Occupat
i
on.
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.
Per
i
odhehasknowny
ou.
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.
.
Per
i
odhehasknowny
ou.
.
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8. WHENAVAI
LABLE.
I
fy
ouar
epr
esent
i
fy
ouar
enoti
n
I
nempl
oy
ement
,
what
empl
oy
ment
,
when
Per
i
odofnot
i
cewoul
d
coul
dy
out
akeup
Yourempl
oy
err
equi
r
e?
Appoi
nt
ment
?
9. DECLARATI
ON
Idecl
ar
et
hatIhav
eanswer
edt
hesequest
i
onst
r
ut
hf
ul
l
yandexact
l
yandt
hatIam notawar
eofanyci
r
cumst
ancesnotdi
scl
osedi
nt
hese
answer
swhi
ch,
i
fknown,
mi
ghtr
i
sedoubt
sast
omyhonest
y
,
sobr
i
et
yorf
i
t
nessf
orappoi
nt
mentt
ot
heTeachi
ngSer
v
i
ce.Iunder
st
andt
hati
fIam
appoi
nt
edt
ot
heTeachi
ngSer
v
i
ceandt
hi
sdecl
ar
at
i
onoranyoft
hepar
t
i
cul
ar
sf
ur
ni
shedbymear
esubsequent
l
yf
oundt
obef
al
sewi
t
hi
nmyown
knowl
edge,
Ishal
l
bel
i
abl
et
odi
smi
ssal
.
Appl
i
cant
’
susual
si
gnat
ur
e…………………………………………………
Dat
e…………………………………………………………
STAFor
m1
REPUBLI
COFZAMBI
A
MI
NI
STRYOFEDUCATI
ON,
SCI
ENCE&VOCATI
ONALTRAI
NI
NG
MOESVTSTATI
STI
CALTEACHERAPPLI
CATI
ONFORM 1
t
eacher
sf
r
om
I
nst
r
uct
i
ons: i
) Thef
or
m mustbecompl
et
edi
n4copi
esbyal
l
qual
i
f
i
edt
r
ai
ned
t
her
ecogni
zedUni
v
er
si
t
i
esandCol
l
eges
i
i
) Theappl
i
cat
i
onf
or
m mustbesubmi
t
t
edt
ot
heDEBSof
f
i
ces
i
i
i
) Ev
er
y
t
hi
ngmustbei
nCAPI
TALl
et
t
er
s
1.
0PERSONALI
NFORMATI
ON
1.
1 Sur
name
Ot
herNames
1.
2 Nat
i
onal
Regi
st
r
at
i
onCar
dNo.
Gender
Nat
i
onal
i
t
y
Dat
eofBi
r
t
h
1.
3 Pl
aceofBi
r
t
h
Vi
l
l
age
Town/
Ci
t
y
Di
st
r
i
ct
Pr
ov
i
nce
1.
4 Languages(
s)
spoken
1.
5 Col
l
ege/
Uni
v
er
si
t
y
Mar
i
t
al
st
at
us
Chi
l
dr
en
Cont
actNo:
Numberof
Ot
her(
Count
r
y
)
Anydi
sabi
l
i
t
y
Qual
i
f
i
cat
i
onobt
0ai
ned
1.
6 Ar
eaofspeci
al
i
zat
i
on(
f
orSecondar
y
Subj
ect1
2.
0 PREFERENCEOFPOSTI
NG
2.
1 1stChoi
ce
Pr
ov
i
nce
Di
st
r
i
ct
2.
2 2ndChoi
ce
Pr
ov
i
nce
Di
st
r
i
ct
2.
3 3rdChoi
ce
Pr
ov
i
nce
Di
st
r
i
ct
Subj
ect2
If
ul
l
yacceptt
hatIwi
l
l
bepost
edwher
emyser
v
i
cesar
eneededandnotnecessar
i
l
yt
ot
hePr
ov
i
nceofmychoi
ce.
2.
4 Dat
e:
Name:
Si
gnat
ur
e:
3.
0 FOROFFI
CI
ALUSEONLY(
Pl
easef
i
l
l
i
nal
l
t
hespaces)
3.
1 Recei
v
edby(
NameandPosi
t
i
on)
3.
2 Dat
e:
I
nst
i
t
ut
i
onal
Ref
.No.
Deci
si
onofDepl
oy
mentCommi
t
t
ee:Candi
dat
epost
edt
o:
3.
4 School
Di
st
r
i
ct
Pr
ov
i
nce
ThePer
manentSecr
et
ar
y
,
Mi
ni
st
r
yofEducat
i
on,
P.
O.Box50093,
LUSAKA
ATTENTI
ON:PERSONNELDEPARTMENT
REGI
ONALCLEARANCECERTI
FI
CATE
Pl
easenot
et
hatMr
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asa.
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desi
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al
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ban
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et
i
r
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r
esi
gned/
di
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beendi
smi
ssedon.
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Theof
f
i
cerowest
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ol
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ngpendi
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amountt
oGRZ,
whi
chmustber
ecei
v
edorwi
t
hhel
df
r
om hi
st
er
mi
nal
pay
ment
s
f
i
nal
i
zat
i
onofpendi
ngcases.
S/
N
1.
I
TEMS
AMOUNT
DETAI
LS
2.
3.
4.
5.
6.
Tot
al
School
dat
eSt
amp
(
Wher
eappl
i
cabl
e)
Icer
t
i
f
yt
hatt
heabov
ei
nf
or
mat
i
oni
scor
r
ect
.
Si
gnat
ur
e.
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Ful
l
namesandf
i
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eno.
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NOTE:Pl
easepr
epar
et
hi
sf
or
mi
n5copi
esand
send4copi
est
ot
hePr
ov
i
nci
al
Educat
i
onOf
f
i
cer
.
Di
st
r
i
ctEducat
i
onBoar
dSecr
et
ar
y
’
s
Dat
est
amp(
Wher
eappl
i
cabl
e)
Icer
t
i
f
yt
hatt
hei
nf
or
mat
i
oni
scor
r
ect
.
Pr
ov
i
nci
al
Educat
i
onOf
f
i
cer
’
s
Dat
est
amp.
Icer
t
i
f
yt
hatt
heabov
ei
nf
or
mat
i
oni
scor
r
ect
.
Si
gnat
ur
e.
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Ful
l
names.
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NOTE:Pl
easecheckespeci
al
l
yi
fof
f
i
cerwasi
nv
ol
v
ed
I
nanyl
ossofpubl
i
cpr
oper
t
yormoneyandsendt
wocopi
eswi
t
ha
cov
er
i
ngmi
nut
ewi
t
hy
ourcomment
s.
Si
gnat
ur
e.
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Ful
l
name.
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Remar
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Tobesubmi
t
t
edi
nor
i
gi
nalonl
y
I
NCONFI
DENCE
PUBLI
CSERVI
CECOMMI
SSI
ON
Appl
i
cat
i
onf
orAppoi
nt
mentt
ot
heVacantPostof
………………………………………………………………………………………………………
i
nt
heMi
ni
st
r
yof
:
………………………………………………………………………………………………….
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ADVERTI
SEMENTNo.………of20….
.
CLOSI
NGDATE:
…………….20….
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PARTA–Tobecompl
et
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i
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m No.6
PA
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NBLOCK
Ot
herNames:
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(
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Dat
eofBi
r
t
h:
……………………………………………………………………………………………………………………….
Pr
esentMi
ni
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yandDepar
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:
…………………………………………………………………………………………….
Dat
eofFi
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………………………………………………………………………………………………………
Pr
esentPosthel
dandDat
eofAppoi
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t
her
et
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…………………………………………………………………………………………………………………….
Educat
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Speci
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Qual
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fany
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Gov
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nmentTr
ai
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sesat
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endedanddat
es:
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er
nmentExami
nat
i
onspassedanddat
es:
…………………………………………………………………………….
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.
……………………………………………………………………………………………………………………………………………
Post
al
Addr
ess:
………………………………………………
Si
gnat
ur
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……………………………………………….
……………………………………………………………………
Dat
e:
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………………………………………………………………………………………………………………………………………….
………………………………………………………………………………………………………………………………………….
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Per
sonal
Char
act
er
i
st
i
cs:
…………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………………….
.
Recommended/
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………………………………………………………………………………………….
St
at
i
on:
……………………………………………………….
.
…………………………………………………………
Si
gnat
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……………………………………………….
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e:
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………………………………………………………………………………………………………………………………………….
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Recommended/
NotRecommended:
………………………………………………………………………………………….
Si
gnat
ur
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……………………………………………………… Dat
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……………………………………………………….
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…………………………………………………………………………………………………………………………………
100m D955 8/
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Or
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ni
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St
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REPUBLI
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Est
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shmentFi
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om v
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whenev
eri
ti
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hodofpay
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.
THESENI
ORFI
NANCEOFFI
CER(
SALARI
ES)
MI
NI
STRYOFFI
NANCE
P.
O.BOX50062
LUSAKA
1. SURNAME(
i
nCAPI
TALLETTERS)………………………………………………………………………………….
FULLCHRI
STI
ANNAMES(
i
nCAPI
TALLETTERS)……………………………………………………………….
NATI
ONALREGI
STRATI
ONNUMBER……………………………………………………………………………….
WORKPERMI
TNUMBERWHEREappl
i
cabl
e………………………………………………………………………
DEPARTMENT……………………………… POSTHELD…………………………………………………………
CONDI
TI
ONSOFSERVI
CE–Cont
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act
/
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manent
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or
my
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r
stappoi
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ment
………………………………………………20………andhav
ebeenpost
edt
o…………………………………
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et
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/
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ghtwhi
chl
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t
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ncabi
n……………………….
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ade…………………….
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andIdi
sembar
ked
at
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20…………
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sey
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el
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rr
et
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epor
t
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orDut
yon…………………………………………………………20…………….
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f
ur
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shmysal
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yt
obepai
d.
(
a) To…………………………………Bankat……………………………………Br
anch…………………………
(
b) Byopenchequeatmyownr
i
sk…………………………………………………………………………………
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……………………………………………….
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manentSecr
et
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/
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OFFI
CERSAREREMI
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ort
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pose.
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Dat
e……………………………………….
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.
.
DI
STRI
BUTI
ON:
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St
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ZAMBI
APUBLI
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APPLI
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FORAPERI
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RTYDAYS
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Myat
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1969(
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THESTATESECURI
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(
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,
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,
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Dat
e:
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Desi
gnat
i
on_
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PARTI
V
(
Tobecompl
et
edbyt
heSal
ar
i
esOf
f
i
cerr
esponsi
bl
ef
ormaki
ngpay
mentandar
r
angi
ngr
ecov
er
i
es)
*Pay
mentofK_
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Kwacha
hasbeenmadebychequeNo._
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r
ecov
er
yoft
headv
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r
angedi
n_
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mont
hl
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l
ment
scommenci
ngt
hemont
hof_
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,
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nt
hemont
hof
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19_
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*TheOf
f
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cerhasbeeni
nf
or
medt
hathi
sappl
i
cat
i
onhasnotbeenappr
ov
ed.
_
_
_
_
_
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Si
gnat
ur
eofOf
f
i
cer
Name:_
_
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¬¬¬¬_
Dat
e:
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Desi
gnat
i
on_
_
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_
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Si
gnat
ur
eofI
nt
er
nalAudi
t
or
Name:
_
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Dat
e:
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Copysentt
ot
heAudi
t
or
Gener
al
on_
_
_
_
_
_
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_
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_
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_
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_
_
_
(
Dat
e)
NOTES:
*Del
et
easappr
opr
i
at
e
(
1) Theappl
i
cat
i
onshoul
dbecompl
et
edandsubmi
t
t
edi
nt
r
i
pl
i
cat
e
(
2) Anappl
i
cantf
orsal
ar
yadv
ancemayber
equi
r
edt
of
ur
ni
shdocument
ar
ypr
oofofhi
s/
herappl
i
cat
i
on.
(
3) Noappl
i
cat
i
onf
oradv
anceofsal
ar
ywi
l
l
beconsi
der
edwhi
l
stt
her
ei
sanout
st
andi
ngbal
ancet
ober
ecov
er
ed
i
nr
espectofanear
l
i
eradv
ance.Fort
hi
spur
poseanadv
ancewi
l
l
notbeconsi
der
edt
ohav
ebeenr
ecov
er
ed
unt
i
l
t
hel
astdayoft
hemont
hi
nwhi
cht
hef
i
nal
r
ecov
er
yi
nst
al
l
menti
smade.
(
4) Af
t
erappr
ov
al
al
l
t
het
hr
eecopi
esshoul
dbesubmi
t
t
edt
ot
hepay
i
ngof
f
i
cer
.
(
5) Thepay
i
ngof
f
i
cershal
l
ar
r
anget
or
ecov
ert
headv
ancei
nnotmor
et
hansi
xi
nst
al
l
ment
sasdi
r
ect
edbyt
he
appr
ov
i
ngof
f
i
ceri
mmedi
at
el
yaf
t
erpay
ment
.Wher
et
her
eci
pi
entoft
headv
ancei
spai
dt
hr
ought
he
mechani
zedsal
ar
ysy
st
em,
t
henecessar
yi
nputshal
l
besubmi
t
t
edt
ot
hecomput
erbef
or
ei
tcl
osesf
ort
he
nextr
uni
nal
l
casesr
ecov
er
yshal
l
bear
r
angedt
hr
ought
heappr
opr
i
at
ewi
l
l
besentt
osuchaut
hor
i
t
y
r
esponsi
bl
ef
orpay
i
ngsal
ar
yt
ot
heof
f
i
cerandacopyoft
heappr
ov
edappl
i
cat
i
onwi
l
l
besentt
osuch
aut
hor
i
t
yt
of
aci
l
i
t
at
et
hi
st
obedone.Onnoaccountshal
l
r
ecov
er
i
esbepost
ponedordel
ay
ed.
(
6) Acopyoft
heappr
ov
edappl
i
cat
i
onf
or
m shoul
dbesentt
ot
heAudi
t
or
Gener
al
f
orhi
sr
ecor
daf
t
erpay
mentof
t
headv
ancehasbeenmade(
Per
sonnel
Di
v
i
si
onCi
r
cul
arNo.B4of1979r
ef
er
s)
.
(
7) Acopyoft
heappr
ov
edappl
i
cat
i
onwi
l
l
bef
i
l
edi
nt
heof
f
i
cer
’
ssal
ar
yf
i
l
ef
orr
ecor
dandaudi
t
.
CONFI
DENCE
Tobecompl
et
edonl
ybyci
t
i
zensof
Zambi
aseeki
ngper
manentempl
oy
ment
REPUBLI
COFZAMBI
A
PSCFor
m No.6
PUBLI
CSERVI
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ON
Appl
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I
MPORTANT
Candi
dat
esshoul
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i
moni
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ncel
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Al
l
sect
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onsoft
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om mustbecompl
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or
mi
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sownhandwr
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t
i
ngandr
et
ur
nedt
ot
he
Secr
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ar
y
,
Publ
i
cSer
v
i
ceCommi
ssi
on,
P.
O.Box50138,
Lusaka
1. Appoi
nt
mentdesi
r
ed.(
Appl
i
cat
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onf
ormor
et
hanonepostmaybemade.Post
sshoul
dbel
i
st
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Post
Mi
ni
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2. Per
sonal
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s.Mi
ss………………………………………………………………………………………………………………….
.
MAI
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Mar
r
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dows)……………………………………………………………………………………….
BLOCK
CAPI
TALS
CHRI
STI
ANNAMESi
nf
ul
l
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.
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.
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.
.
.
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HOW LONGHAVEYOUBEENI
NZAMBI
A……………………………………………………………………………………………….
ADDRESS(
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(
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c)Tel
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i
fav
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Nat
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……………………………………………………………………
Di
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ear
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.
REPUBLI
COFZAMBI
A
MI
NI
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ON
MOGESTATI
STI
CALTEACHERAPPLI
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ONFORM 1
t
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s
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I
nst
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1PERSONALI
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name(
I
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1.
1 Sur
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1Nat
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Regi
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4
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4.
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1Languages(
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at
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spoken
1.
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3
Mal
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1.
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4Nat
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2.
5Dat
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Di
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Pr
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4.
3. NumberofChi
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6 Ar
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1.
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4 Anydi
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Subj
ect1
Subj
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Onl
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2.
0 PREFERENCEOFPOSTI
NG
2.
1 1stChoi
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Pr
ov
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Di
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2.
2 2ndChoi
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Pr
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2.
4
Dat
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Name:
Si
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3.
0
FOROFFI
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3.
2
Dat
e:
I
nst
i
t
ut
i
onal
Ref
.No.
3.
3
Deci
si
onofDepl
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mentCommi
t
t
ee:Candi
dat
epost
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o:
3.
4
School
Di
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Pr
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Rur
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/
Ur
ban
Thi
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