1. Form ZNEBC01
Zimbabwe Namibia Employment Boot Camp
Application Form
P.O Box 23762,Windhoek,Namibia
APPLICANT INFORMATION
(All Information provided herein shall be kept confidential and shall not be distributed to any third parties
except where highlighted in the relevant sections below)
Forename(s): Surname
Date of birth: Sex: Marital Status: Race:
Current address:
City: Suburb: Street: Passport No.
Email: Phone: Cell: Whatsaap No:
Facebook User Name: Skype: Linkedin:
PASSPORT DETAILS AND RESIDENCE
Passport No. Issue Date: Expiry Date: Place of Issue:
Nationality: Country of Residence: Nationality of Passport:
CURRENT EMPLOYMENT INFORMATION
(This information is for Know your Client (KRCs) and is private and confidential)
Current employer:
Employer address: Duration: Start Date: Type of Employment:
Phone: E-mail: Fax:
City: Suburb Work Email:
Position: Website: Current Salary: Expected income:
Email Form To
euglen@ledgerwoodaccfirm.co
Insert Passport Photo
Here
2. Form ZNEBC01
EMERGENCY CONTACT
Next of Kin: Forename(s) Surname(s)
Address:
City: Suburb: Email: Phone:
Relationship: Whatsaap No: Skype: Facebook:
SPOUSE INFORMATION IF APPLICABLE
Name: Maiden Name: Address:
Date of birth: PHONE: EMAIL: Passport No:
Employer: Address:
Phone: E-mail: Fax: Website:
City: Suburb: Postal Code: Country:
EDUCATIONAL QUALIFICATIONS
ORDINARY LEVEL
Subject Grade Subject Grade Subject Grade Subject Grade
1.English .2 .3 4.
5. 6. 7. 8.
9. 10. 11. 12.
ADVANCED LEVEL
Subject Grade Subject Grade Subject Grade Subject Grade
1.English .2 .3 4.
OTHER CERTIFICATES (not degrees)
INSTITUTION PROGRAMME GRADE/AWARD YEAR
6. Form ZNEBC01
WORKING EXPERIENCE
EMPLOYER 1
Employer:
Employer address: Position:
Phone: E-mail: Fax: Website:
City: Suburb: Work Email: Duration:
Country: Salary Range: Contact: Reason for leaving:
EMPLOYER 2
Employer:
Employer address: Position:
Phone: E-mail: Fax: Website:
City: Suburb Work Email: Duration:
Position: Current Salary Range Contact: Reason for Leaving:
EMPLOYER 3
Employer:
Employer address: Position:
Phone: E-mail: Fax: Website:
City: Suburb Work Email: Duration:
Position: Current Salary Range Contact: Reason for Leaving:
EMPLOYER 4
Employer:
Employer address: Position:
Phone: E-mail: Fax: Website:
City: Suburb Work Email: Duration:
Position: Current Salary Range Contact: Reason for Leaving:
7. Form ZNEBC01
EMERGENCY CONTACT
Next of Kin:
Address:
City: Suburb: Email: Phone:
Relationship: Whatsaap No:
REFERENCES
Name Address Phone EMAIL
PREFERRED EMPLOYMENT
JOB TITLE SECTOR CITY AVAILABILITY
8. Form ZNEBC01
CAMP PACKAGES
Tick Appropriate Box according to requirements.
BOOT CAMP ACCOMMODATION HOTEL/GUEST HOUSE ACCOMMODATION PRIVATE ACCOMMODATION
Single Room $1000 for 15 Days Single Rooms $1500 per 15 Days Single Rooms for 15 Days (Applicable rates at the time))
Shared Rooms $600 for 15 Days Shared Rooms $1000 per 15 Days Shared Rooms for 15 Days (applicable rates at the time)
TRANSPORT
Tick appropriate box according to requirements.
Boot Camp Transfer Shuttle Public Transport Minibuses/ Buses Air Transport
Harare to Windhoek Route: The Bus Leaves Harare at 11am from
Causeway Post Office, Harare on the 8th
of August 2015 and
travels via Bulawayo, Plumtree Boarder Post, Francistown in
Botswana to Mumuno Boarder Post Botswana Namibia. The
Shuttle Service will arrive in Windhoek Namibia on the 9th
of
August 2015 at the Boot Camp Guest House.
Harare to Windhoek Route: The Bus Leaves Harare at 11am
from Causeway Post Office, Harare on the 9th
of August 2015
and travels via Bulawayo, Plumtree Boarder Post, Francistown in
Botswana to Mumuno Boarder Post Botswana Namibia. The
Shuttle Service will arrive in Windhoek Namibia on the 10th
of
August 2015 at Soweto Market.
-Air Namibia 10 August 2015 at 13:00 Harare-Windhoek
-South Africa Airways via Johannesburg Daily
-British Airways Via Johannesburg Daily
Cost $150 Harare to Windhoek, Namibia via Francistown
Botswana
$100 per Trip and no additional services
Depending with availability, the cost is around $700 return
Return trip from 25 August 2015 via Caprivi Strip, Victoria Falls,
Bulawayo to Harare.
Return Trip Via Francistown, Botswana, Plumtree, Bulawayo to
Harare.
Return Via Hosea Kutako International Airport to Harare
International Airport
Air Namibia- Via Lusaka Zambia
SA Airways – Johannesburg, South Africa
British Airways- Via Johannesburg, South Africa
Cost $150 Windhoek Via Victoria falls to Harare, Zimbabwe Cost $100 Via Francistown to Harare, Zimbabwe Covered in the total airfare.
REGISTRATION FEES
Registration Fee Due Date: 31 /07/2015 Late Registration Fee Due Date: 5 August 2015 Last Minute registration Fee by 5-810 August 2015
Registration includes reservation for Boot Camp Participation,
Namibia Tours, Materials, Transport and Accommodation
reservations.
Registration includes reservation for Boot Camp Participation,
Namibia Tours, Materials, Transport and Accommodation
reservations.
Registration includes reservation for Boot Camp
Participation, Namibia Tours, Materials, Transport and
Accommodation reservations.
Fee Us$100.00 Fee $200.00 Fee $300.00
CRIMINAL CONVICTIONS
Have you been convicted of any offence against the law other than minor traffic offences? YES NO
If yes, give details:
Do you have any criminal charges pending other than minor traffic offences? YES NO
9. Form ZNEBC01
DECLARATION
I, (full name) declare that to the best of my knowledge, the
answers to the questions in this application are correct.
I understand that this form, together with the written material I have supplied, and evaluative material including any interview notes, will be held
confidentially and used only for the purposes of this application Employment Boot Camp and onward submission to prospective employers. I agree to
the Zimbabwe Society in Namibia of any future change to the information supplied during the course of this application process and/or for my records
should I be successful in obtaining employment in Namibia
I agree to such pre-employment checks as deemed necessary being undertaken by Zimbabwe Society in Namibia and any prospective employers to
which my Curriculum Vitae and Certificates may be forwarded for the any role I may apply or the Employment Boot Camp may have applied for on my
behalf. I understand that should I be appointed to any role, I must provide certified proof of identity (such as a birth certificate or passport) and
evidence of New citizenship of my country of origin, residence or a valid work permit prior to commencing employment.
I understand that should I be appointed to the role I must provide original or certified documentation supporting my educational qualifications. For
overseas qualifications, if I have not had my qualification(s) evaluated by the Namibia Qualifications Authority, I may be required to do so before any
offer of employment can be confirmed. (Note: For further information refer www.namqa.org. I understand that the information pertaining to my health
may be requested for Permit Applications and hereby abide by all terms and conditions of the Zimbabwe Namibia Employment Boot Camp 2015 as
provided herein, on website, blogs and all other materials that i may receive in connection with this Boot Camp.
I understand that if any false or misleading information is given, or any material fact suppressed, It may jeopardies my applications and I may face
criminal prosecutions in term of the laws of the Republic of Namibia and my country of origin.
Signature of applicant
Date: Initials:
Signature of spouse (only if for a joint membership):
Date: Initials:
Do you wish to be registered as a Member of Zimbabwe Namibia Society (Yes)(No) Should we forward your details to Zimbabwe Namibia Society to be a Member (Yes) (No)
