Application Form

For employment with

PIAGET ACADEMY SCHOOLS

Please complete pages 1-4 of this form fully and accurately where relevant. If there is not
enough space, you may attach further details on a separate sheet. All applications will be
treated in confidence. Please type or complete in BLOCK letters.

(1) Personal Details

Date of Full Name (underline surname): Application for the
Application: Mr/Ms/Mrs/Dr Post of:

Permanent Address: Zip:

Current Address: Zip:

Mobile Number: Home Phone: Work Phone: Email Address &

Skype Name:

Citizenship: Gender: Date of Birth: Place of Birth:

Identification No.: Passport No. Religion: Marital Status:

How did you learn about this employment opportunity?

Online Job Portal (please Ad in Newspaper Referral by: Others (please
specify where): specify):

(2) Educational and Professional Qualifications

Name of Highest Academic
School/College/Polytechnic Country Duration of Course Qualifications Attained
/University Attended
(Secondary & Post Secondary)
From (Year) To (Year)

Other credentials/ licenses/ professional affiliations, etc., which are relevant to the job(s) for which you are
applying.
(3) Academic Scholarships and Awards
From (Year) To (Year) Name of Scholarship/Awards (including PSC Awards)

(4) Professional memberships, other trainings undertaken, other awards, medals and prizes.
Year Description

(5) Results of GCE O Level and A Level/Polytechnic Diploma exams or equivalent

O Level / O Level Equivalent A Level / Polytechnic Diploma exams or equivalent
Subject Grade Subject Grade

(6) Latest/Final Year Bachelor degree results or equivalent

University Attended: Country:
Course of Study: Merit: Yes/No
Class of Honours: CAPS/GPA:
Subject Grade Subject Grade

(7)Language Proficiency (Fluent/Fair/Poor)

Written Spoken

(8) ECA/CCA/Sports/Hobbies
From (Date) To (Date) ECA/CCA/Sports/Hobbies Position/Rank/Grade/Level of
Participation

(9) Employment Details (Start with the most recent job)

Company Month/Year Position Last Drawn Salary Reason for Leaving
 May we make enquiries from Have you ever been charged in Have you ever been dismissed by
your past and current court? any previous employer?
employer?

Are you currently employed? How much advance notice do you need to give to
your current employer?

If offered employment, when can you commence Expected Salary

Do you have any relatives or friends working in Piaget Academy affiliated companies? If so, please give
details

(10) Particulars of parents, spouse & children

Name Relationship Citizenship Occupation

(11) Character References

Name:
Relationship:
Address:
Contact Details:
Occupation:
Name:
Relationship:
Address:
Contact Details:
Occupation:
Name:
Relationship:
Address:
Contact Details:
Occupation:
(12) Medical Details
Any current or past medical condition(s) which may affect your teaching responsibilities? If yes, please
provide details.

Any current or past medical condition(s) which requires/required regular treatment? If yes, please
provide details.

Have you ever been hospitalized for any medical/surgical reason? If yes, please provide details.

(For female employees only) Are you pregnant? If yes, please state date of delivery

Person to notify in case of emergency:

Name:
Relationship:
Address:
Contact Number:

(13) Passions
What are your passions?

(14) Aspirations
What are your aspirations?

I declare that the particulars in this application and the attached sheets are true to the best of my
knowledge and belief, and I have not willfully suppressed any material fact.

Signature of Applicant: __________________________________