UMASIPALA WASETHEKWINI 
ISICELO SOMSEBENZI 

ISIKHUNDLA OSICELAYO: ......................................................... IGRADE:.......................................................................................... 
ISERVICE UNIT/UMNYANGO:................................................................................................................................................................. 
INOMBOLO YESAZISO SESIKHALA SOMSEBENZI.: ......................... Noma USUKU LWESAZISO:.................................................. 

1.  OKUMAQONDANA NAWE (NGAMAGAMA AMAKHULU) 
Isibongo .................................................................................. Mnu/Nkk/Nksz ............................................................................... 
Amagama .................................................................................. Inombolo Yocingo: Emsebenzini: ..................Ekhaya:.......................... 

Ikheli lasekhaya .................................................................................................................................... Ikhodi yeposi Add ...........................................................................................................................................Po stal Cod  

Ikheli leposi.............................................................................................................................................. Ikhodi yeposi  
Iminyaka yobudala.                      Usuku lokuzalwa  

Unazo yini izihlobo eziqashwe uMasipala? .................................................................................................................................................. 
Igama: ..................................................................................................... Izikhundla abakuzo ................................................................. 

Ngokwenhloso yokuthobela izimiso ze Employment Equity Act ka 1998 siza ufake lolu phawo (T) ebhokisini elifanele  
Owomdabu wase Afrika  Owomdabu waseNdiya  Ikhaladi  Umlungu  Okhubazakile  Owesilisa  Owesifazane  

Ubuzwe ......................................................................... Inombolo Kamazisi  

2.  Isimo sempilo 
Isho isimo sempilo yakho....................................................................................................................................................................... Nika imininingwane yanoma ikuphi ukugula, ukuhlinzwa okukhulu noma ukukhubazeka okungase kube nomthelela kulo msebenzi owufakela isicelo:.................................................................................................................................................................................. 

3.  Isipiliyoni somsebenzi 

IService Unit okuyo ............................................................. Umnyango............................................................................................ 
ISikhundla okuso................................................................. Igrade okuyo........................................................................................ 

Usuku owaqashwa ngalo kule Grade  
Ubude beminyaka usebenzela uMasipala ............iminyaka, ........... izinyanga.  Usuku owaqala ngalo umsebebenzi  

B. 
Uma ungaqashiwe uMasipala: 

Umsebenzi owenzayo .......................................................................................................................................................................... Iholo lakho ................................................................... Izibonelelo....................................................................................................... Imininingwane yezikhundla oke waziphatha phambilini. (Faka amakhophi ezitifiketi zokusebenza njengobufakazi, noma usho ukuthi zinga tholakala). 
Umqashi  Isikhundla  Isikhathi  Isizathu sokushiya  Isitifiketi sokusebenza onaso. Yebo/cha  
Kusukela  kuya  
1)  
2)  
3)  
4)  



C. Wake waqashwa ngu Masipala phambilini? ........ ..................................  Umnyango ....................................................................... 

Uma kunjalo, ishoisikhathi kusukela  kuya  Inombolo yomsebenzi  

D. 	Kungabe uyilunga noma ilunga lomndeni wakho liyilunga le close corporation, inkampani ewumfelandawonye, lenkampani noma ubambe iqhaza ebhizinisini ethile? Yebo/Cha........................ uma kunjalo, siza usho imininingwane.............................................. .............................................................................................................................................................................................................. 
............................................................................................................................................................................................................... 


4. 	 OKUPHASIWEYO 
a) Imfundo 
(i)	   Isikole ..................................................................................................  Ibanga oliphasile ......................................................... 

*Ikhophi noma isitatimende sohlu lwezifundo kanye namamaki/amasimboli okuhlolwa (sumbols) kumelwe kufakwe. 
(ii)	   Imininingwane yeziqu/ama Diploma/izitifiketi onazo Uhlobo lweziqu/iDiploma/isitifiketi Usuku owasithola ngalo Lapho wasithola khona 

b) Ubuchwepheshe ezilimini  Ukukhuluma  Ukufunda  Ukubhala  Ukuhlolwa okuphasile  
1) isiNgisi  
2) isiZulu  
3) Olunye  

5.	
   Chaza ngokugcwele isipiliyoni sakho esihambisana nalesi sikhundla ngamagama amafushane: (Uma kubonakala kudingeka, faka incwadi eceleni echaza kabanzi ngalokhu): ............................................................................................................................................................................................................... 

............................................................................................................................................................................................................... 
............................................................................................................................................................................................................... 


6.	
   Kwake kwenzeka ukuthi (a) ulahlwe yicala lobugebengu? .................................................................................................. 


(b) uxoshwe noma ucelwe ukuthi usule emsebenzini? ...................................................................... 


7. 	
 Izincwadi zokushayela onazo 


Inombolo Ingabe ilayisense ibhalwe 
Imoto esindayo/elula Ezishintshayo/eshintshwayo ikhodi yelayisense. Icala lemoto Yebo/cha 
................................................. ....................................... ...................... ........................... ................................................... 
................................................. ....................................... ...................... ........................... ................................................... 

8.  PHENDULA KUPHELA UMA KUYISIKHALA SIKA ARTISAN NOMA KUDINGEKA OPHASELE UKUBA YI ARTISAN: 
(a) Uke wasebenza njenge aprentisi kulomsebenzi ofuna kuwo isikhala sokusebenza na?  (Phendula Yebo noma Cha) .................. 

Lapho wasebenza khona Inombolo yokubhalisela Umsebenzi .............................................  nje nge aprentisi ............................................... Inkontileka .......................................... 

Ngalokhu ngenza isicelo sesikhundla sokusebenza esishiwo kulo Masipala futhi ngiyaqinisa ukuthi izimpendulo zami emibuzweni ebekwe ngaphezulu ziyiqiniso lonke. Ngiyaqonda ukuthi ulwazi/imininingwane engamanga noma edukisayo ingaba isizathu sokuba ngixoshwe. 
Usuku: ..................................................................... Isiginesha: ................................................................................................ 

UNGAFAKI IZITIFIKETI UQOBO LWAZO - FAKA AMAKHOPHI KUPHELA 
LESISIKHALA SISETSHENZISWA YINHLOKO YOMNYANGO 
KUPHELA .................................................................................................................................................................................................... 
...................................................................................................................................................................................................................... 
.......................................................................................................................(Lelifomu liyatholakala ngeSingisi) 



