ANA TEACHER MODERATION MARKING APPLICATION FORM 2015
ANA MODERATION MARKING APPLICATION FORM SCHOOL/OFFICE BASED CS STAFF
CLOSING DATE: 17 APRIL 2015
Instructions for completing this form
1. Indicate whether you are applying to mark/moderate Mathematics, Home language or First Additional Language, where applicable.
2. This form must be attached to a 2 pages CV of the applicant.
3. An application does not guarantee an appointment as applicants will exceed the number of markers required.
4. Successful applicants will be paid in accordance with the PAM document.
5. Any person found to have given fraudulent information will be disqualified from moderation marking process.
6. Use X to make selections.
SUBJECT: __________________LANGUAGE: _____________ GRADE: POSITION APPLIED FOR (Choose only one option)
Marker
Senior Marker
Chief Marker
SPECIAL NEEDS MARKING COMPETENCY
De-brailled
Deaf adapted
PERSAL NO.
ID NO:
TITLE
EQUITY CRITERIA: Gender
Race
Female
Male
Asian
African
Coloured
White
SURNAME
FULL FIRST NAMES
POSTAL ADDRESS
POSTAL CODE
TEL. (HOME)
CELL NO
EMAIL ADDRESS
CURRENT INSTITUTION
POSITION
ARE YOU REMUNERATED BY THE DEPARTMENT?
YES
NO
DO YOU INTEND LEAVING THE DEPARTMENT FOR ANY REASON WHATSOEVER PRIOR TO 30 OCTOBER THIS YEAR?
YES
NO
QUALIFICATIONS – Pease indicate ONLY the highest APPROPRIATE qualification
ACADEMIC QUALIFICATION PROFESSIONAL QUALIFICATION
DEGREE/DIPLOMA/CERTIFICATE:
DEGREE/DIPLOMA/CERTIFICATE:
EXAMINING BODY:
EXAMINING BODY:
YEAR OBTAINED:
YEAR OBTAINED:
NUMBER OF YEARS TEACHING OR SUPPORTING THE SUBJECT AND PHASE WHICH YOU ARE APPLYING FOR :
LANGUAGE(S) IN WHICH YOU ARE ABLE TO MARK
I hereby certify that the above Information is correct in all respects.
______________________________ _________
SIGNATURE OF APPLICANT DATE:
I hereby CERTIFY that the above information is correct in all respects and that the applicant is supporting the
CLOSING DATE: 17 APRIL 2015
Instructions for completing this form
1. Indicate whether you are applying to mark/moderate Mathematics, Home language or First Additional Language, where applicable.
2. This form must be attached to a 2 pages CV of the applicant.
3. An application does not guarantee an appointment as applicants will exceed the number of markers required.
4. Successful applicants will be paid in accordance with the PAM document.
5. Any person found to have given fraudulent information will be disqualified from moderation marking process.
6. Use X to make selections.
SUBJECT: __________________LANGUAGE: _____________ GRADE: POSITION APPLIED FOR (Choose only one option)
Marker
Senior Marker
Chief Marker
SPECIAL NEEDS MARKING COMPETENCY
De-brailled
Deaf adapted
PERSAL NO.
ID NO:
TITLE
EQUITY CRITERIA: Gender
Race
Female
Male
Asian
African
Coloured
White
SURNAME
FULL FIRST NAMES
POSTAL ADDRESS
POSTAL CODE
TEL. (HOME)
CELL NO
EMAIL ADDRESS
CURRENT INSTITUTION
POSITION
ARE YOU REMUNERATED BY THE DEPARTMENT?
YES
NO
DO YOU INTEND LEAVING THE DEPARTMENT FOR ANY REASON WHATSOEVER PRIOR TO 30 OCTOBER THIS YEAR?
YES
NO
QUALIFICATIONS – Pease indicate ONLY the highest APPROPRIATE qualification
ACADEMIC QUALIFICATION PROFESSIONAL QUALIFICATION
DEGREE/DIPLOMA/CERTIFICATE:
DEGREE/DIPLOMA/CERTIFICATE:
EXAMINING BODY:
EXAMINING BODY:
YEAR OBTAINED:
YEAR OBTAINED:
NUMBER OF YEARS TEACHING OR SUPPORTING THE SUBJECT AND PHASE WHICH YOU ARE APPLYING FOR :
LANGUAGE(S) IN WHICH YOU ARE ABLE TO MARK
I hereby certify that the above Information is correct in all respects.
______________________________ _________
SIGNATURE OF APPLICANT DATE:
I hereby CERTIFY that the above information is correct in all respects and that the applicant is supporting the