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.