PERSONAL DETAILS First name Surname ID Number Gender: Ethnic Group Race Physical address

Postal code Postal address

Postal code Province Where did you hear about the bursary? Cell phone number

Alternative phone number

E-mail Address What is your preferred method of contact? (cell phone or e-mail)

EDUCATION DETAILS Are you currently studying? (Yes/No) If yes, what level are you studying? (Grade 12, 1st, 2nd, 3rd, or 4th year) Specify your current/intended Field of Study Specify your current/intended University

The CSIR is a responsible employer; we have put measures in place to ensure that equity is implemented such that it best serves the interests of the organisation and South Africa as a whole. This speaks to the CSIR’s commitment to the Employment Equity Act of 1998. By applying for this position at the CSIR, the applicant understands, consents and agrees that the CSIR may solicit a credit and criminal report from a registered credit bureau and/or SAPS (in relation to positions that require trust and honesty and/or entail the handling of cash or finances) and may also verify the applicant’s educational qualifications and employment history. The CSIR reserves the right to remove the advertisement at any time before the stated closing date as well as reserves the right not to appoint if a suitable candidate is not identified. Page 1 of 2

SCHOOL EDUCATION School name Province Please provide Grade 11/12 Final Results: Subject

%

Total Average:

TERTIARY EDUCATION Start Year Average Marks Please attach the Academic Record as issued by the University

I acknowledge that the information provided is correct and true to the best of my knowledge.

Signature of applicant/guardian:____________________________Date:_____________________________ Kindly fax your completed application to 012 841 3951 or email to [email protected] or post to CSIR Recruitment Centre, PO Box 395, Pretoria, 0001.

The CSIR is a responsible employer; we have put measures in place to ensure that equity is implemented such that it best serves the interests of the organisation and South Africa as a whole. This speaks to the CSIR’s commitment to the Employment Equity Act of 1998. By applying for this position at the CSIR, the applicant understands, consents and agrees that the CSIR may solicit a credit and criminal report from a registered credit bureau and/or SAPS (in relation to positions that require trust and honesty and/or entail the handling of cash or finances) and may also verify the applicant’s educational qualifications and employment history. The CSIR reserves the right to remove the advertisement at any time before the stated closing date as well as reserves the right not to appoint if a suitable candidate is not identified.

CLOSING DATE: 15 JUNE 2015

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First name Surname ID Number Gender: Ethnic ... - University of Pretoria

Jun 15, 2015 - ... we have put measures in place to ensure that equity is implemented such that it best serves the interests of the organisation and South Africa.
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