Job Application Form at URSB

Please fill in all the information (where applicable)

1. Personal Information

Name (as in National ID or passport):

……………………………………………………………………………………………………
(Surname, First Name, other)
National-ID/Passport No: ……………………………………………………………………...

Citizenship: Ugandan Other (specify) …………………………………...

A foreigner shall require a work pass to work in Uganda

Address: ………………………………………………………………………………………
Postal Code: ……………………………………………………………………………………
Telephone No: ………………………………………………………………………………..
Email address: ………………………………………………………………………………..

2. Application

Job being applied for …………………………………………………………………………..

Please tell us why you applied for this job and why you think you are the best person
for the job.
……………………………………………………………………………………………………
……………………………………………………………………………………………………
……………………………………………………………………………………………………

3. Academic Qualifications

Date Qualifications Obtained (‘O’/’A’

Schools/Institutions Attended Grades/Class
From To Levels, Diploma, Degree)
 Job Application Form at URSB

4. Other Qualifications / Courses Attended / Awards Attained

Date
Qualifications / Awards Obtained Awarding Institution
From To

5. Employment History

Date Firm/Institution Key Reason(s) for

Position Held
From To (in chronological order) Responsibilities Leaving

6. Details of Current Employment

Present Employer: ……………………………………………………………...……………

Designation: …………………………………………………………………………………….
Present monthly salary: ……………………………………………………………………….
Bonus: …………………………………………………………………………………………..
Other Benefits: ...……………………………………………………………………………….

Key Responsibilities: …………………………………………………………………………

……………………………………………………………………………………………………
Notice required (to end present employment): ………………………………… (Weeks)

Reason for leaving: …………………………………………………………………………….

7. Referees

Please give details of two referees whom we may approach for references.

Name: …………………………………………………………………………………………...
Designation: …………………………………………………………………………………….
Organisation Name: ……………………………………………………………………………
Contact No: ……………………………………………………………………………………..
Email Address: …………………………………………………………………………………
 Job Application Form at URSB

Name: …………………………………………………………………………………………...
Designation: …………………………………………………………………………………….
Organisation Name: ……………………………………………………………………………
Contact No: ……………………………………………………………………………………..
Email Address: …………………………………………………………………………………

Name: …………………………………………………………………………………………...
Designation: …………………………………………………………………………………….
Organisation Name: ……………………………………………………………………………
Contact No: ……………………………………………………………………………………..
Email Address: …………………………………………………………………………………

I verify that the above information is correct to the best of my knowledge. I accept that
providing deliberately false information could result in my dismissal.

Signature: ……………………………………………………………………………………….
Date: …………………………………………………………………………………………….
 Job Application Form at URSB

Section B: For administrative purposes only

NRIC No : ____________________ Date of Birth : ____________________

Age: _______ Race : ____________________ Religion : _______________

Marital Status : ____________________ Sex : Male / Female