MINISTRY OF THE PUBLIC SERVICE AND ADMINISTRATIVE REFORM Fiscal Stamp REPUBLIC OF CAMEROON Peace - Work - Fatherland Stick 4x4 Passport size Photograph
APPLICATION FORM FOR THE SPECIAL RECRUITMENT OF 50 PUPIL MAGISTRATES AND 30 COURT REGISTRARS OF ENGLISH EXPRESSION INTO THE NATIONAL SCHOOL OF ADMINISTRATION AND MAGISTRACY (NSAM) FOR THE 2020/2021 ACADEMIC YEAR
SUBMISSION RECEIPT N* [1]
EXAMINATION CENTRE CHOSEN (2): BUEA ☐ BAMENDA ☐ GAROUA ☐ YAOUNDE ☐
Name and surname: _________________________________________________________
Date of birth (DD/MM/YYYY): |___|___|/___|___|/___|___| Place of birth: _________________________________________________________
Place of residence: _________________________________________________________ Sex (2): Male ☐ Female ☐
For the recruitment of: _________________________________________________________
Region of origin: _________________________________________________________ Division: _________________________________________________________ Sub Division _________________________________________________________
Ethnic group: _________________________________________________________ Profession: _________________________________________________________
Nationality: _________________________________________________________ Profession of spouse: _________________________________________________________
Father’s name: _________________________________________________________ Mother’s name: _________________________________________________________
Father’s division of origin: _________________________________________________________ Mother’s division of origin: _________________________________________________________
Marital status: 1=Married 2= Single 3=Divorced 4= Widow ☐
Full address: _________________________________________________________
Required certificate: _________________________________________________________ Major field: _________________________________________________________ Grade: _________________________________________________________
Issuing Institution: _________________________________________________________
Examination Center: _________________________________________________________ Obtention date: _________________________________________________________
Other certificate: _________________________________________________________ Obtention date: _________________________________________________________ Major field: _________________________________________________________
Disability 1=Yes 2=No ☐ Nature of disability: _________________________________________________________ Degree of disability: _________________________________________________________ Invalidity card N*: _________________________________________________________
Language of expression (2): French ☐ English ☐ Candidate’s phone number: _________________________________________________________
Place of deposit: _________________________________________________________
List of documents enclosed (3):
| 1- Application form duly filled and signed by the candidate | ☐ | 6-Four passport size photographs | ☐ | 11- Certificate of individuality (where applicable) | ☐ |
|---|---|---|---|---|---|
| 2-Certified true copy of birth certificate | ☐ | 7-Medical certificate | ☐ | 12- Photocopy of marriage certificate(where applicable) | ☐ |
| 3- Certified true copy of the required certificate | ☐ | 8- Receipt attesting payment of the registration fee | ☐ | ☐ | |
| 4-Attestation of presentation of the original certificate | ☐ | 9- Envelope bearing a CFA 500 francs Stamp and the candidate’s address | ☐ | ☐ | |
| 5-Certificate of non conviction | ☐ | 10-Photocopy of the National Identity Card | ☐ | ☐ |
At _________________________ On _________________________
Candidate’s signature _________________________
MINISTRY OF THE PUBLIC SERVICE AND ADMINISTRATIVE REFORM SPECIAL RECRUITMENT INTO NSAM FOR 2020/2021 ACADEMIC YEAR (1) SUBMISSION RECEIPT N* [1]
Name and surname: _________________________________________________________
Session of: _________________________________________________________
For the recruitment of: _________________________________________________________
Grade: _________________________ Examination centre chosen: _________________________
Has effectively submitted his/her file on: _________________________ at _________________________
REPUBLIC OF CAMEROON Peace - Work - Fatherland Attach a 4x4 Passport size Photograph Issued by: _________________________
(1) File registration number (2) Tick where appropriate NB: This receipt is strictly individual and shall be presented wherever requested.