Registration form – page 2 - Kerfield recruitment

Registration form

Page 2

Current Remuneration Package - Base Salary:

Travel Allowance:

Cellphone Allowance:

Company Car:

If yes, state approx. value:

Medical Aid: Total Value

Pension/Provident Fund: Total Value

Performance Bonus/13th Cheque:

Other (Meals/Uniform/Entertainment):

Cost to Company Salary:

When is your next increase due?

How many days leave do you currently get?

Availability/Notice Period:

Are you vaccinated?

Rate your health:

What is your work preference?

Have you ever been Black Listed/Arrested for Criminal Activity/ Convicted of Criminal Activity?

If yes, please provide details and list companies with whom you are under review:

References:

Terms & Conditions:

I declare that all written/ verbal information supplied to Kerfield Recruitment is correct; to falsify such information is an illegal offence.

I authorize Kerfield Recruitment to conduct both a Credit and Criminal Check and to convey the results thereof to the client.

I allow Kerfield Recruitment to keep my personal information on file for future suitable roles.

Full Name:

Email:

Date/Month/Year:

Signed & Accepted:

I agree