JOB APPLICATION FORM - Business Development

1. CONTACT INFORMATION

Salutation(*)

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First name:(*)

Please let us know of your first name

Middle name:(*)

Please let us know of your middle name

Last name:(*)

Please let us know of your Government known last name

Date of Birth(*)

/ / Kindly input your date of birth

Current email:(*)

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Gender(*)

Male

Female

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Mobile phone number:(*)

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Secondary phone number:

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PIN Number(*)

Invalid Input! Kindly input your KRA pin number

ID Number(*)

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2. ADDITIONAL INFORMATION

Please select the highest level of education you have attained to date(*)

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Are you currently an CIM/MSK member(*)

Yes

No

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Do you have a Certificate of Proficiency in Insurance or Exemption letter fro IRA(*)

Yes, Certificate of Proficiency

Yes, Exemption letter from IRA

Yes, Diploma in Insurance

None of the above

Other

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What are your monthly Salary Requirements?(*)

Please input your data as Kshs without any comma Eg.30000

List all companies you have ever worked for(*)

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Industry of previous or current employement:(*)

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Which of the following clearly states your previous/current employement situation(*)

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Kindly list all insurance companies you know of

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In your opinion, Kenya's best insurance company is

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3.1 EDUCATION - Undergraduate

Undergraduate University Name:

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Country of University?

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Degree:

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Major or Specialization

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Minor:

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Graduation year:

/ / Kindly input graduation year

GPA / Grade:

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3.2 EDUCATION - PostGraduate

PostGraduate University Name:

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Country of University:

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Degree:

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Subject:

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Thesis topic:

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Graduation year:

/ / Kindly input graduation year

Advisor name:

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Advisor email:

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Advisor mobile number

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3.3 ADDITIONAL EDUCATION - College / Technical

Name of institution:

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Country:

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Coursework:

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Description of studies:

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3.4 PROFESSIONAL QUALIFICATION (Highest relevant qualification)

Name of institution:

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Country of Professional qualification

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Description of studies:

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GPA / Grade:

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Graduation year:

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4. PROFESSIONAL MEMBERSHIP

Organization:

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Membership Level:

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Country of professional qualification

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5.1 EMPLOYMENT HISTORY

This is a summarized description of your job experience. We will only require your most recent employer / current employer. If never employed fill in only the mandatory fields.

Salutation

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Supervisor's Name:

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Supervisor's Job Title:

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Supervisor's Email:

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Supervisors Mobile Number:

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If this is your current employer, may we contact them while considering your application?

Yes

No

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6. REFERENCES

Approximate number of car owners you know(*)

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Please provide information on 5 reliable professional references who you have worked with and can verify your skills, capabilities and knowledge. Only one reference (Reference 5) should be your close family member.

We will make every effort to verify them. All details are mandatory

FIRST REFERENCE

Salutation(*)

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Full name:(*)

Required answer in this field

Relationship:(*)

Required answer in this field

Organization / Company:(*)

Invalid Input! Required answer in this field

Title / Position:(*)

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Email:(*)

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Phone:(*)

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SECOND REFERENCE

Salutation(*)

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Full name:(*)

Invalid Input! Required answer in this field

Relationship:(*)

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Organization / Company:

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Title / Position:(*)

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Email:(*)

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Phone:(*)

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THIRD REFERENCE

Salutation(*)

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Full name:(*)

Invalid Input! Required answer in this field

Relationship:(*)

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Organization / Company:(*)

Invalid Input! Required answer in this field

Title / Position:(*)

Required answer in this field

Email:(*)

Required answer in this field

Phone:(*)

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FOURTH REFERENCE

Salutation(*)

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Full name:(*)

Required answer in this field

Relationship:(*)

Required answer in this field

Organization / Company:(*)

Invalid Input! Required answer in this field

Title / Poston:(*)

Required answer in this field

Email:(*)

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Phone:(*)

Invalid Input! For non-US numbers, please include country code and full phone number while omitting leading "0" and "+"

FIFTH REFERENCE

Salutation(*)

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Full name:(*)

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Relationship:(*)

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Organization / Company:(*)

Invalid Input! Required answer in this field

Title / Position:(*)

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Email:(*)

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Phone:(*)

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8. OTHER INFORMATION

Department you are looking for a job(*)

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Confirm position you are applying for(*)

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What kind of job are you interested in(*)

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I am interested in(*)

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Which of the following remuneration structures are you most comfortable with(*)

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If you do not get this job will you accept the position Business Development Executive to be paid by commission?(*)

Yes, if I don't get this job I will accept a commission only job

No, if I don't get this job I will not accept any other position

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Which of the following are you willing to sell on commission should you not get the advertised job(*)

Do you own a motor vehicle:(*)

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In less than 20 words what do you see yourself doing in the next 5 years?(*)

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Briefly write down a unique skill that may be beneficial for this position applied(*)

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Other than friends and family what strategy will you use to build sales(*)

Kindly input your sales strategy

9. CURRENT ADDRESS

Are you the main income earner in your household?(*)

Yes

No

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Kindly choose which of our locations is closest to you(*)

Kindly choose which of our locations is closest to you

Main office: Eaton Place, Gigiri, Nairobi

Currently where are you applying this job from

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Is your home …

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Country:(*)

Please let us know your country

County in which you reside & work(*)

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Province in which you reside & work(*)

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City / Town in which you reside & work(*)

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Location or Estate in which you reside(*)

Please input your location or estate without any numbers

Street address in which you reside(*)

Invalid Input! Street Address Is the name of the street / road where you live

Your Postal address / Code(*)

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Alternate email in case your other email does not work

Invalid Input. Please put a valid email address. No school or work accounts as they often don't allow the sending of large attachments. Please use a free web-based service (i.e. gmail, hotmail) for correspondence