FORM/RBA/001 Retirement Benefits Authority
FORM/RBA/001 Retirement Benefits Authority
FORM/RBA/001 Retirement Benefits Authority
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Passport No. …………………………………………………………………...
(If dead the above questions should nevertheless be answered, if living, his address
should be given above).
8. Give particulars of educational, professional or technical qualifications stating where and when obtained, with
particulars of examinations passe:
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4. ……………………………………………………………………………………………………………………
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9. What language(s) do you know?
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10. Give full particulars of all your employment since leaving school or college and period of unemployment.
Attach copies (not originals) of available testimonials. IT IS ESSENTIAL THAT THESE PARTICULARS
ARE GIVEN IN FULL.
If space is insufficient, a separate sheet of paper may be attached.
Names and full address of employer, department, division or Position/Grade or rank where Date (Month and Year)
section* applicable
From To
Month Year Month Year
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3. Name …………………………………………………… …………………………………
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Address……………………………………………… ………………………………… …… …… …… ……
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4. Name…………………………………………………… …………………………………
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Address…………………………………………….. ………………………………… …… …… …… ……
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5. Name …………………………………………………… ………………………………… …… …… …… ……
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Address ……………………………………………. …………………………………
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6. Name…………………………………………………… …………………………………
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Address……………………………………………….. …………………………………
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7. Name………………………………………………… …………………………………
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Address…………………………………………………
8. Name ……………………………………………………
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Address………………………………………………
* Delete as necessary
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11. State briefly the qualifications and/or experience you possess which you consider best fit you for this post.
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12. Do you suffer from any physical impairment? …………………. if so give details…………………………
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13. Have you ever been convicted of any charge in a Court of Law?………………………………………………..
The fact of an applicant declaring that he has been convicted of an offence will not necessarily debar him from
employment in the Retirement Benefits Authority. Each case will be considered on its merits having regard to the
nature and the circumstances of the offence.
Have you ever with or without being convicted, been made the subject of a probation order? ………………………
14. Have you even been dismissed or otherwise removed from any previous employment? ……………………….
15. I hereby certify that I do not suffer from any pecuniary embarrassment………………………………………...
(signature)
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testimonials should not be given; nor shall the
names of Directors or staff of the Retirement 2. Name: Mr/Mrs/Miss ………………………………
Benefits Authority.
Address: ……………………………………………….
Occupation: …………………………………………..
17. State the last post for which you were interviewed by the Authority, and date of interview:
POST: …………………………………………….
DATE: …………………………………………..