Ndubaluba Instructor Training Programme Application Form

Ndubaluba ITP Application Form

This application form is for applicants wishing to apply for the Instructor Training Programme at Ndubaluba.

Step 1 of 5

Date*
DD slash MM slash YYYY
Where did you see this position advertised?*
Other:*
If you chose "other" for where you saw this position advertised, please let us know where below:
Your Personal Details
Name*
First Last
Date of Birth*
DD slash MM slash YYYY
Gender*
Your permanent address:*
Your present address:*
Email*
Enter Email Confirm Email
Phone Number*
Nationality*
National Registration Card Number
Please include your NRC number if you are based in Zambia.
Passport Number
Place of Issue
Date of Issue
DD slash MM slash YYYY
Date of Expiry
DD slash MM slash YYYY
How long do you envisage staying at Chengelo?*
Marital status*
Name of spouse:*
Profession of spouse:*
If your spouse is a teacher, please specify which subject areas.
Details of children
Click the "+" icon to add additional rows.
Name Gender Age School Grade
Indicate your level of health*
Do you have chronic ailments?*
- Yes
- No
Details of chronic ailments*
Are you presently receiving treatment for any illness?*
- Yes
- No
Details of treatment*
When was your last physical check up?*
DD slash MM slash YYYY

Your First Referee
Your first referee should be someone who knows you professionally.
Name*
First Last
Address*
Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country
Phone*
Email*
Enter Email Confirm Email
Your Second Referee
Your second referee should be someone who knows you spiritually (e.g. your pastor, minister or church elder).
Name*
First Last
Address*
Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country
Phone*
Email*
Enter Email Confirm Email
Document Uploads*
Please upload a photo of yourself (and spouse if applicable) and scans of relevant supporting documents: 1. CV 2. Degree certificates etc. 3. Practicing licenses etc. (Maximum of 10 files, each under 5mb)
Drop files here or

Accepted file types: jpg, jpeg, pdf, png, gif, Max. file size: 10 MB, Max. files: 10.
Personal Guarantee*
I certify that I have not purposely withheld any information that might adversely affect my chances for participating on the Instructor Training Programme at Ndubaluba / Chengelo. I attest to the fact that the answers given by me are true & correct to the best of my knowledge and ability. I understand that any omission (including any misstatement) of material fact on this application or on any document used to secure can be grounds for rejection of my application or, if I am engaged by Chengelo School, terms for my immediate dismissal from the School. I permit the School to examine my references, record of employment, education record, and any other information I have provided. I authorize the references I have listed to disclose any information related to my work record, spiritual life and my professional experiences with them, without giving me prior notice of such disclosure. In addition, I release the Chengelo School, my former employers & all other persons from any and all claims, demands or liabilities arising out of or in any way related to such examination or revelation. I confirm that all the details I have entered into this form are true. I understand that if the information is false or misleading it will disqualify me from my appointment or after appointment could lead to a disciplinary action or dismissal.
- I agree
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Phone
This field is for validation purposes and should be left unchanged.

Institution	From (Month/Year)	To (Month/Year)	Qualifications Gained

Organisation	Address & Contact Details	Position Held	Brief Description of Duties & Responsibilities	From (Month/Year)	To (Month/Year)	Reason for Leaving

Ndubaluba Instructor Training Programme Application Form

Ndubaluba ITP Application Form

Step 1 of 5

Your Personal Details

Your Qualifications and Experience

Your Experience with Children

Your Christian Background

Your First Referee

Your Second Referee

Name	Gender	Age	School Grade

School	Subject studied	Level

Language	Fluency