Application for First Time Appointment As an Educator

FTA 01

Application for First Time Appointment as an Educator This form is applicable to all Non Funza Lushaka Bursary Holders Fill in or tick the boxes where appropriate. All information must be provided

Nature of Application

MEC Bursary Holder KZN Bursary Holder Non-Bursary Student

Surname Initials

ID Number Race: A C I W Gender F M For Employment Equity Your Postal Your residential Address this year Address this year

Your Postal Your residential address next year Address next year

Your Parents/Next- your parent/next of kin's residential of kin's postal address address

Contact Nos: Your Cellular phone number - - Mother's Cellular phone number - - Father's Cellular phone number - - Home telephone number - - Friend/spouse Cellular phone number - - Fax No - - Email Address: This year: Next Year (Set up a Google or Yahoo email address if you do not have one) Qualification B.Ed PGCE NPDE Other:

Your University

Phase Specialisation: FP FP/IP IP IP/SP SP SP/FET FET FP: Foundation Phase IP: Intermediate Phase SP: Senior Phase FET: Further Education and Training Phase Only tick ONE of the boxes above If you are qualified to teach in the foundation phase of Foundation/Intermediate phase combination, tick the language(s) of instruction in which you will be qualified to teach Afrikaans English isiNdebele isiXhosa isiZulu Sepedi Sesotho Setswana Siswati Tshivenda Xitsonga If you are qualifying to teach in the Intermediate, senior phase of FET, tick the language(s) of instruction in which you will be qualified to teach. English Afrikaans Both

If you are qualifying to teach in the Intermediate Phase or Senior Phase, tick the LEARNING AREA(S) you will be qualified to teach Social Sciences Arts and Culture Mathematics Technology Life Orientation Eco. & Manage. Sciences Natural Sciences isiXhosa Afrikaans English isiNdebele Setswana isiZulu Sepedi Sesotho Tick only the learning areas which you SiSwati Tshivenda Xitsonga complete methodology courses for

If you are qualifying to teach in the FET phase, tick the SUBJECT(S) you will be qualified to teach Accounting Agric Manage Practices Agricultural Sciences Agricultural Technology Business Studies Civil Technology Comp. Applic. Technology Consumer Studies Dance Studies Design Dramatic Arts Economics Electrical Tech Eng Grapics & Design Geography History Hospitality Studies Information Technology Life Orientation Life Sciences Mathematics Mathematical Literacy Mechanical Technology Music Physical Sciences Religion Studies Tourism Visual Arts Afrikaans English isiNdebele isiXhosa isiZulu Sepedi Sesotho Setswana SiSwati Tshivenda Xitsonga Tick only the learning areas which you complete methodology courses for Area of Appointment Preference: Please list the following Districts in your order of preference for appointment Ilemebe Pinetown Umlazi Sisonke Ugu Umgungundlovu Amajuba Othukela Umzinyathi Empangeni Obonjeni Vryheid

1 2 3 4 5 6 7 8 9 10 11 12 If you are able to offer any EXTRAMURAL/EXTRA-CURRICULAR activities, list them here.

Declaratio I declare that the information supplied above is correct. In signing this form I acknowledge receipt of the letter from the KwaZulu-Natal n: Department of Education regarding my placement obligations and the placement process. I understand the placement process.

Signature Date