Online Form
 
  * Fields are mandatory
  * Candidate Details:
     
  Legal Full Names:
  Surname:
  Maiden Surname (if applicable):
  Date of Birth :
  ID Number:
  Passport Number:
  Contact Numbe:
     
  Reason for Enquiry:
     
  Pre-employment Screening
  Other-specify
     
  MATRIC QUALIFICATION
     
  Matric Qualification R80.00
     
 
     
  Year Obtained:
  Certificate Number:
     
  ATTACH CERTIFICATE:
 
   
  TERTIARY/ACADEMIC QUALIFICATION
     
  Tertiary/Academic Qualification R70.00
     
 
     
  Institution Attended:
  Student Number:
  Year Started:
  Qualification Obtained:
     
  ATTACH CERTIFICATE:
 
   
  LICENCE
     
  Drivers Licence R55.00
  Professional Driving Permit (PrDP) R55.00
  Licence and PrDP R90.00
  Drivers Licence History R70.00
     
  IDENTITY DOCUMENT (ID)
     
  ID Number Verification R10.00
  ID Verification R20.00
     
  EMPLOYMENT REFERENCE CHECK
     
  Single Check (1 Employment History) R80.00
  Standard Check (3-5 Employment History) R300.00
  Executive Check (5-8 Employment History) R600.00
  Directorship Information R90.00
  Work Permit R1300.00
     
  PROFESSIONAL MEMBERSHIP ASSOCIATION
     
  Professional Membership Association R50.00
     
 
     
  Association Name:
  Year Joined:
     
  COMPANY REGISTRATION VERIFICATION
     
  Company Registration Verification R300
     
  CCMA REPORT
     
  CCMA Report R50.00
     
  FRAUD LISTING CHECK
     
  Fraud Listing Check R60.00
     
  INSTITUTION ACCREDITATION
     
  Institution Accreditation R120.00
     
   
 

Declaration by candidate

I hereby authorise the Company's duly authorised verification agent, Ntsika Background Checks (PTY) Ltd (NBC), to forward any personal information I have provided in support of my application to verification information authorities acting on behalf of NBC (including but not limited to the South African Police Service, South African Government authorities and any

educational, training, credit bureau institutions) for the purpose of verifying information requested by the company or company agent.  I furthermore authorise any authorised agents to conduct all background checks including but not limited to credit bureau search, drivers licence, employment history, criminal record, professional membership and other relevant checks in the pre or post-employment screening process and where necessary to request the South African Police Services, Tertiary Education Institutions to furnish personal information regarding my criminal background, criminal history, previous conviction and/or any other relevant information such as usually furnished by the Criminal Records Centre of the South African Police Services, and Tertiary Education Institution in this regard, to NBC.  I understand that any information furnished to NBC and the Company and will be disclosed to me.  I unconditionally indemnify NBC and its verification information suppliers against any liability that may result from furnishing information in this regard. I fully understand that this information is solely for the purpose of my proposed employment.

In cases where an agent is completing this form on behalf of the candidate, the consent form signed by the candidate should be available on request.

   
  * I have read and understand the terms and conditions:
     
  Yes
     
 
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