KTTI/HR/EA/001

APPLICATION FOR EMPLOYMENT FORM

Please complete this form in BLOCK letters as appropriate and submit to

the Principal, Karumo Technical Training Institute, P.O.BOX 276 - 60602
KIANJAI, KENYA
1. Vacancy Applied For

Vacancy/Post: Vacancy No:

Department:
2. Personal Details

Name of applicant:
( Surname) First Name Other
Name(s):
Title: (Prof/Dr/Mr./Mrs./Miss/Ms/Rev)
Date of Birth: Gender: Male Female
(dd-mm-yyyy)
Nationality: ID.No/Passport No.:
Postal Address: Town : Code:
Home County: Sub county: Constituency:
Telephone: Mobile: E-mail address:
Alternative contact person: Telephone:
3. Applicants in the institute only
Department: Section:
Present Substantive Post: Job Grade:
Effective date:
(dd mm yyyy)
Upgrading (if applicable) post: Effective date:
(dd-
mm-yyyy)
Terms of Service: Permanent & Pensionable Contract Casual
Internship

Page 1 of 4
 KTTI/HR/EA/001

4. Applicants in Private/NGO/Other Sectors

Current employer: Position held:

Effective date: Gross Salary (monthly) Ksh.

5. Other Details
Indicate the language(s) you are proficient in:

Do you suffer from any physical impairment? Yes No. Reg. No.

If yes give details:

Have you ever been convicted of any criminal offences or a subject of probation
order?
Yes No
Have you ever been dismissed or otherwise removed from employment? Yes
No
If Yes, State reason (s) for dismissal/removal:
Effective date:
(dd-mm-yyyy)
Have you ever been interviewed by Karumo Technical Training Institute before? Yes
No
If Yes, State the Post: Interview date:
(dd-mm-
yyyy)
(Declaring the above information will not necessarily debar an applicant from
employment in the Board. Each case will be considered on its own merit)
6. Academic /Professional/Technical Qualifications (Starting with the Highest)
Year University/ Award/Attainment Courses Area of Class/
College/ (e.g.Degree, (e.g. Specialization Grade
Fro To School Diploma, PhD,
m Certificate) Msc, BA)

Page 2 of 4
 KTTI/HR/EA/001

7. Other Relevant Courses & Training/Registration/Membership to

Professional Bodies/Institute
From To Institute/College Courses Details

8. Employment Details - where applicable (starting with the current or most recent)
Year Job Group/Grade Ministry/State Department/
/Scale Institution/ Organization
From To Designation/ Position
Gross Monthly Salary
(dd-mm-yyyy) (dd-mm-yyyy) (Ksh.)

9. Briefly state your current duties, responsibilities and assignments (if any)
……………………………………………………………………...................................................................................................
……………………………………………………………………………………………………..……………….…..…..…….....
…………………………………………………………………………………………….…………………..…………….……....
……………………………………………………………………………………………………………….…..…………….…....
............................................................................................................................................................................................................
............................................................................................................................................................................................................
............................................................................................................................................................................................................
10. Please give details of your abilities, skills and experience which you consider relevant to the position applied for. This
information may include an outline of your most recent achievements and your reasons for applying for this post.
…………………………………….……………………….…..........................................................................................................

Page 3 of 4
 KTTI/HR/EA/001

………….…………………………………………………………………………………………………………………………
…………………………………………………………………………………………………….……………………………….
………….…………………………………………………………………………………………………………………………
............................................................................................................................................................................................................
............................................................................................................................................................................................................
............................................................................................................................................................................................................

11. Referees (people who have interacted with you professionally)

1. Full Name:……………………………………………………………………………………………………………………...
Occupation:………………………………………………………………………………………………………………………….
Address:…………………………………Post Code:……………………………...City/Town: …………....................................
Mobile No:…………………………………… E-mail address:……………………………………………………….................
Period for which the referee has known you:……………………………………….………………………………........................

2. Full Name:……………………………………………………………………….……………………………………………...
Occupation:………………………………………………………………………..…………………………….………………….
Address:…………………………….Post Code:……………………………….......City/Town: ………………………………...
Mobile No:……………………....................... E-mail address:……………………………………………………......................
Period for which the referee has known you:……………………………………….…………………………………….……......

12. Declaration
I certify that the particulars given on this form are correct and understand that any incorrect /misleading information may
lead to disqualification and/or legal action.

Date: ……………………………. ……………………………..

(dd-mm-yyyy) Signature of the Applicant

Page 4 of 4