Self Declaration Form

SBM TOWER

1, Queen Elizabeth II Avenue Port Louis, MAURITIUS

(+230) 202 1111

sbm@sbmgroup.mu

Branches Opening Hours

Monday to Thursday : 9 a.m. to 3.15 p.m.

Friday : 9 a.m. to 4 p.m.

CSR

+(230) 202 1262

csr@sbmgroup.mu

Job Application

Post Applied for

Post Applied for
	Post Applied for	Item weight
	Post Applied for	Item weight
	Post Applied for	Item weight
	Post Applied for	Item weight
	Post Applied for	Item weight

Title

Surname

Other Names

Maiden Name (If Applicable)

Gender

Male

Female

Marital Status

Single

Married

Divorced

Separated

Widowed

Residential Address

Email Address

Email hidden

Home Phone No.

Office Phone No.

Mobile Phone No.

Date of Birth

Nationality

Country of Origin

NIC

Passport Number

School

School
	School	Item weight
	School	Item weight
	School	Item weight

From year

From year
	From year	Item weight
	From year	Item weight
	From year	Item weight

To year

To year
	To year	Item weight
	To year	Item weight
	To year	Item weight

SC RESULTS

GCE

OTHER

Year

SUBJECT

SUBJECT
	SUBJECT	Item weight
	SUBJECT	Item weight
	SUBJECT	Item weight
	SUBJECT	Item weight
	SUBJECT	Item weight
	SUBJECT	Item weight
	SUBJECT	Item weight
	SUBJECT	Item weight
	SUBJECT	Item weight

GRADE

GRADE
	GRADE	Item weight
	GRADE	Item weight
	GRADE	Item weight
	GRADE	Item weight
	GRADE	Item weight
	GRADE	Item weight
	GRADE	Item weight
	GRADE	Item weight
	GRADE	Item weight

HSC RESULTS

HSC

GCE

OTHER

Year

Principal Level

Principal Level
	Principal Level	Item weight
	Principal Level	Item weight
	Principal Level	Item weight

GRADE

GRADE
	GRADE	Item weight
	GRADE	Item weight
	GRADE	Item weight

Subsidiary Level

Subsidiary Level
	Subsidiary Level	Item weight
	Subsidiary Level	Item weight
	Subsidiary Level	Item weight

GRADE

GRADE
	GRADE	Item weight
	GRADE	Item weight
	GRADE	Item weight

Qualification/ Field of Study

Class/Division

University/Institution

From year

To year

Qualification/ Field of Study

Class/Division

University/Institution

From year

To year

Qualification/ Field of Study

Class/Division

University/Institution

From year

To year

Professional Certificates

Professional Certificates
	Professional Certificates	Item weight
	Professional Certificates	Item weight
	Professional Certificates	Item weight

English

Written

Spoken

French

Written

Spoken

Other

Written

Spoken

NUMBER OF YEARS OF EXPERIENCE IN THE FIELD OF APPLICATION:

PRESENT EMPLOYER :

EMPLOYER

JOB TITLE

From

PRESENT BASIC SALARY (Rs)

PRESENT TOTAL PACKAGE(Rs)

EXPECTED TOTAL PACKAGE(Rs)

DESCRIPTION OF DUTIES

PREVIOUS EMPLOYER :

EMPLOYER

JOB TITLE

FROM

BRIEF DESCRIPTION OF MAIN DUTIES

REASON FOR LEAVING

EMPLOYER

JOB TITLE

FROM

BRIEF DESCRIPTION OF MAIN DUTIES

REASON FOR LEAVING

EMPLOYER

JOB TITLE

FROM

BRIEF DESCRIPTION OF MAIN DUTIES

REASON FOR LEAVING

Comments

Please provide details of two referees. At lease one of the referees should be your current or previous employer.

Referee 1

Name

Job Title

Company Name

Address

Contact Number

Referee 2

Name

Job Title

Company Name

Address

Contact Number

Have you ever been convicted of any crime, fraud or misdemeanour?

Yes

Are you willing to undergo a medical examination if you are selected?

Yes

State if you have any relative working for SBM Group.

Yes

If yes, please state name(s) and the nature of relationship

I hereby declare and accept that to the best of my knowledge, all information given by me is true and complete.

Please note that you will be required to submit evidence for all information (including salary) provided above during the selection process.

If you are unable to submit your application, please send us your resume at careers@sbmgroup.mu

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Submitted by BZ2168 on Thu, 09/28/2023 - 09:41

SBM

Self Declaration Form

28 Sep 2023, 09:41

English

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