PUBLIC SERVICES COMMISSION
JOB APPLICATION FORM
FILE NO. ……………………….
PHOTOGRAPH
(CURRENT PASSPORT POTOGRAPH NOT MORE THAN THREE (3) MONTHS OLD)
APPLICATION FOR APPOINTMENT TO A POST IN THE GHANA PUBLIC SERVICES
(Applicants are warned that if they knowingly make any false statement they may render
themselves liable to prosecution and to cancellation of their appointments.)
Post: .........................................................................……
Ministry/Department/Agency: …...................................…
PART I
1. Surname: ......................................................................................................…….…….Sex: ……………
(Use Block Capitals)
2. Other names: ...................................................................................................................................……
3. Previous names (if name has been changed): ..................................................................……
4. (a) Postal Address: .................................................................................................................................
(Use Block Capitals)
(b) Residential Address: ............................................................... Tel. No(s): ………………………........
5. Address in Ghana/Overseas (if different from above): ……………………………………..…………..……..
……………………………………………………………..…………………………………………………………....
6. Date of Birth (dd/mm/yy): ....................................... Place of Birth (City/Town/Country):
...........................
7. Nationality and how acquired: ...................................................................................................................
8. Present Appointment or Employment (if any): ……………………….……… Salary: ...........………….……
9. Full name of spouse (if married): .............................................................. Nationality ....………………....
10. Number of Children: ................................ Sons: ............................. Date of Birth: …..............................
Daughters: ……………... Date of Birth: ……….………………
11. (a) Father's Name in full.................................................................................…………………………….
(b) Father's Nationality: ...................................................... (a) Home Town: ……………………..........
(b) Region: ….…………………………..….
12. (a) Mother's Name in full:................................................................................…………………………….
(b) Mother's Maiden Name (if any): ...............................................................………………..…………..
(c) Mother's Nationality: ......................................................... (a) Home Town: ..……...…………..........
(b) Region: ………..…………………..….
(Note: Questions 11 and 12 should be answered even if those concerned have died.)
13. Passport number, date (dd/mm/yy) and place of issue: .................................…………………………….
14. Have you ever been convicted of a Criminal Offence?: ...................If "Yes", give details……………….
………………………………………………………………………………………………………………………….
………………………………………………………………………………………………………………………….
15. Have you ever been dismissed or otherwise removed from any of the Public Services in Ghana?,
If "Yes", give details ...........................................................……………………………………………….…….
.……………………………………………………………………………………………………………………..….
………………………………………………………………………………………………………………………….
16. Are you bonded to serve either the Government or any organisation in any capacity? ……………….
If "Yes", give details including the date of the expiry of the Bond……………………………………………...
…………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………
N.B. - Ghanaian applicants should state whether they held government awards, or financial assistance from a public service agency
THIS PART TO BE COMPLETED BY NON-GHANAIAN CANDIDATES ONLY
Non-Ghanaians applying from Western Europe should, on completion return this Form to the Director of Recruitment (Overseas), Ghana High
Commission, 248-250 Tottenham Court Road, London, W.I.
17. Have you any objection to reference being made to your previous or present Employers? .................
18. If engaged, how soon would you be able to take up the appointment...................................................?
PART II
1. Names of Educational Institutions attended with dates of entry and leaving in each case.
Dates
Educational Institution From To
2. Particulars of educational (academic) qualifications with dates on which each was obtained
………………………………………………………………………………………………………………………….
………………………………………………………………………………………………………………………….
……………………………………………………….…………………………………………………………………
…………………………………………………………………………………………………………………………
3. Particulars of professional or technical qualifications with dates on which each was obtained
…………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………
N. B. – Applicants should attach copies of evidence of professional or graduate status including CVs and National Service
Certificate. Original certificates should not be sent at this stage.
NB – Applicants from Ghana should submit their completed forms to the various Organisations.
PART III
1. EMPLOYMENT HISTORY
From To Name and Full Address of Employer State: (A) Positions Held
(B) Particulars of Work Done
(C) Reasons for Leaving Employer
Month and Year Month and year A)……………………………………………………
B)……………………………………………………
……………………………………………………….
C)…………………………………………………….
A)……………………………………………………
B)……………………………………………………
……………………………………………………….
C)…………………………………………………….
A)……………………………………………………
B)……………………………………………………
……………………………………………………….
C)…………………………………………………….
A)……………………………………………………
B)……………………………………………………
……………………………………………………….
C)…………………………………………………….
A)……………………………………………………
B)……………………………………………………
……………………………………………………….
C)…………………………………………………….
A)……………………………………………………
B)……………………………………………………
……………………………………………………….
C)…………………………………………………….
A)……………………………………………………
B)……………………………………………………
……………………………………………………….
C)…………………………………………………….
N.B- Medical Applicants should clearly state the names and addresses of hospitals in which they were trained as well as those in
which they held Housemanship appointment, Testimonials from their hospital administration should be attached.
2. What other posts in the Ghana Public Services have you ever applied for? (Give details)
…………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………….
.…………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………
3. Personal References.
Give the names and addresses of two responsible persons who know you very well and have given their
permission/consent to act as your referees either in private life or in business; one at least should be well
acquainted with you in private life. The names of relatives must not be given nor those of distinguished
persons unless they know you well. In respect of distinguished persons, you must seek permission from
them.
Testimonials from your personal referees should not be sent. Copies of other testimonials may be
attached Originals should not be sent at this stage
1. Name…………………………………………………………
Postal Address: ……………………………………………
Phone No(s): ……………………………………………….
Email(s): …………………………………………………..
Occupation………………………………………………….
Period during which he/she has known you………………
2. Name: ………………………………………………………
Postal Address: ……………………………………………
Phone No(s): ……………………………………………….
Email(s): …………………………………………………..
Occupation………………………………………………….
Period during which he/she has known you…………….
7. I CERTIFY THAT the information given on this form is true/correct.
Signature of Applicant: …..…………………………………..…....
Date: (dd/mm/yy): …………………………………20………....….
PART IV
(To be completed by or on behalf of the Head of Organisation of an applicant who is already in the Ghana Public Services)
I do/do not consider the candidate qualified in terms of the advertisement; I do/do not recommend him for
the vacancy. My reasons are given below:
…………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………
……………………………………………………………………………………………………………….………………………………………………………………
Name: ………………………..………..
Signed: ………………………………...
Designation: ……………………….….
Official Stamp..........…………..….…..
Date (dd/mm/yy): ……........ 20……….
DEPARTMENTAL FILE
