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APPLICATION FOR LECTURING PART-TIME

REPORT 191 / NATED Name of Campus applying to?

Instructions:
1. Complete one application form for each subject applied for
2. This application form must be accompanied by a comprehensive Curriculum Vitae as well as certified copies of all qualifications

APPLICATION FORM
(To be completed by the applicant)

1. SUBJECT AND LEVEL:

2. COLLEGE/CAMPUS

3. TITLE INITIALS SURNAME

4. ID NUMBER

5. PERSAL

6. TEL NUMBER (W)

7. CELL NUMBER

8. E-MAIL ADDRESS

9. FAX NO

10. HIGHEST QUALIFICATION OBTAINED

11. HIGHEST QUALIFICATION OBTAINED IN THE SUBJECT APPLIED FOR AND NUMBER YEARS OF TEACHING THE SUBJECT

12. ARE YOU CURRENTLY TEACHING THE SUBJECT:

YES NO

13. RECORD OF RESULTS*

SUBJECT:
Academic Cycle**:
Number Students Enrolled Number Students Written Number Students Passed Pass %

Academic Cycle**:
Number Students Enrolled Number Students Written Number Students Passed Pass %

Academic Cycle**:
Number Students Enrolled Number Students Written Number Students Passed Pass %

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* SUBJECT – Previous 3 academic cycles’ data required.
**Cycle – is for example Trimester 2 of 2013 or Semester 1 of 2014

Declaration by the Applicant

I hereby declare that the information supplied on this application form is correct in every detail.

I am also aware that the submission of this application does not necessarily guarantee my appointment to the position applied for.

___________________________________________ ____________________________________
Signature of Applicant Date

CERTIFIED AS CORRECT AND RECOMMENDED BY SUPERVISOR:

___________________________________ _______________________________________ _______________________


Name (Printed) Signature Date

COLLEGE STAMP

For Office Use Only

Recommended: Not Recommended

Comments:

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Name (Printed) Signature Date

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