CLECC - Application Form for the Post of Permanent Secretary

Section I.Personal Details

Particulars

First Name / Mr ☐ / Mrs ☐ / Ms ☐
Last Name
Date of Birth / Place of Birth
Current Nationality[1] / Nationality at Birth
Honors[2]
Convictions[3]

Languages

Mother Tongue
Please indicate your level of proficiency in the following (using theEuropean Common Reference Framework – see Additional Information Paper in the application pack).
Read / Write / Speak
English / Choose an item. / Choose an item. / Choose an item. /
French / Choose an item. / Choose an item. / Choose an item. /
Spanish / Choose an item. / Choose an item. / Choose an item. /

Section II.Contact Details

Postal Address
Telephone No. (Day)
Telephone No. (Evening)
Email Address

Section III.Qualifications

Please use this section to details your educational achievements. Please ensure that, at a minimum, you demonstrate required qualifications as set out in the advertisement.

Highest Educational Achievement / - Please Select - /

University Details

Please provide details of your higher education/university degrees.

Name / Address / Type Grade / Subject / From / To

Secondary Education

Please provide details of your secondary education.

Name of School
Address
Date Started
Date Finished
Please provide details of the subjects studied and examined.
Qualification / Grade / Subject

Please continue, if required, in the additional information section.

Section IV.Employment History

Please provide details of your employment history starting with the present one. Provisions for the latestthree (including current) are provided here.Please detail all others in the additional information section.

Note that the details part is limited to 1750 characters – approximately 250 words.Any additional employments listed in the additional information section must not exceed the character limit.

Have you had any breaks in employment over the past 10 years? - Please Select -

Present Employer

Name of Employer
Address of Employer
Exact Job Title
Date Started
Please provide a description of your work including: roles and responsibilities, whether you have management responsibilities and/or any notable achievements attained.

Previous Employer (1)

Name of Employer
Address of Employer
Job Title
Date Started
Date Finished
Please provide details of your work including roles and responsibilities, whether you have management responsibilities and/or any notable achievements attained in that role.

Previous Employer (2)

Name of Employer
Address of Employer
Job Title
Date Started
Date Finished
Please provide details of your work including roles and responsibilities, whether you have management responsibilities and/or any notable achievements attained in that role.

Section V.Competence Statements

Please provide written examples of where you have demonstrated the required competences. Please refer to the Additional Information paper in the application pack that outlines thebehaviour and skills expected. Please note each competence is limited to 1750 characters.

Leading & Communicating

Project/Budget Management

Stakeholder Engagement

Making Effective Decisions

Integrity

Section VI.Statement of Vision

Please explain your vision for the post of Permanent Secretary. (Please note this is limited to 15000 characters – approximately 3 sides of A4).

Section VII.Additional Information

Please use the box below to provide any additional information either required (e.g. continuation of employment history) or that you would like to be considered (e.g. publications).

Section VIII.References

Please provide the names of two persons, not related to you, that you have known for at least 2 years who will vouch for you, your qualifications and your character.

Full Name / Occupation / Contact Details

Section IX.Declaration

By signing this application I confirm that the information I have provided in this application is accurate and complete. I agree to supply, on request, any documentary evidence required to support the information provided by me.

I acknowledge that any misrepresentation or material omission, even unintentional, may result in the rejection of my application or the annulment of any subsequent appointment.

Signature

Date

Please send your completed application form,by the closing date,tothe CCLEC Secretariat at .

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[1]If your present nationality is different from your nationality at birth please provide details of how and when acquired, and, whether you hold dual nationality.

[2]Please give details of any honours you hold.

[3]Please state any conviction (criminal or administrative) or any pending case that may lead to such.