Title Prof. Dr. Mr. Mrs. Ms. Miss. First Name Surname Residential Address Street Suburb City / Town Postcode Phone Home Phone Work Cell Phone Email RSA ID Home Language Other Languages (DEAT will request proof of language proficiency if any language is not one of the 12 South African languages ) Hands On Date 20 - 24 February 2012 27 February - 2 March 2012 ADDITIONAL INFORMATION REQUIRED BY THETA Date Of Birth Gender Male Female Equity Black African Black Coloured Black Indian Black Asian White Current Occupation Years At Present Employer Experience Socio - economic Status Employed Not Working Disabled Housewife Scholar Pensioner Looking for work None of the above Not wishing to work Not looking for work Disability Status None Communication Emotional Hearing Impaired Intellectual Mental Movement Impaired Multiple Physical Sight Impaired Speech Impaired Unknown A Short CV must be submitted With This Form