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Ing current employer) E. REFERENCES Name Post held YES From MM YY Relationship to you NO To MM YY Reason for Leaving Contact Number DECLARATION I declare that all the information provided (including any attachments) is complete and correct to the best of my knowledge. I understand that any false information supplied could lead to my application for the learnership being disqualified. Signature:_______________________ Date:__________________ Page 4 of 4 .

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