Institute of Technology Blanchardstown

Institiúid Teicneolaíochta Baile Bhlainséir

Application form – Guidelines

Completing the application form
  1. Applications must be submitted using the Institute’s application form. The application form must be type written and all sections completedin full. Supplementary documentation eg CV, is not required and willnot be considered as part of the application.
  1. If applying for more than one post, a separate application form mustbe completed. Full and accurate information should be provided asthe information may be used to shortlist candidates for interview.
  1. Candidates may be required to provide documentary evidence tosupport any statement made on the application form.
  1. Where academic achievements and/or specific work experience arerequired for a post, they must be achieved by the latest date forreceipt of applications. Degrees or other higher educationqualifications are reckoned only from the date of conferral.
  1. Applications will be treated in complete confidence and will be used in accordance with the policy and procedures of The Data Protection Act 1988

and the Data Protection (Amendment) Act 2003.

  1. Applicants are asked to provide contact details for three referees, one of whom should be a current or most recent employer. Permissionto contact referees and to seek attendance records from them will beassumed unless otherwise stated on the application form.

Returning the Form

For further information and to access application forms and job descriptions for the above vacancies, see or contact Linda on 01 8851102.

One signed original and six photocopies of your application should be posted or hand delivered to Linda Fitzpatrick, HR Department, Block A, Institute of Technology Blanchardstown, Blanchardstown Road North, Blanchardstown, Dublin 15. Please submit all applications on or before 12 noon on Friday 25th May 2018.

Please ensure that you receive an acknowledgement of receipt of your application within 7 working days.

Late applications will not be considered.

Note: Canvassing will disqualify applications

Institute of Technology Blanchardstown

Institiúid Teicneolaíochta Baile Bhlainséir

APPLICATION FORM – ACADEMIC POSITIONS

Specific post applied for / Temporary Wholetime/Part Time Pro Rata Assistant Lecturer in Computing (panel)
Reference Number / P18/25
Surname
First name
Permanent address
Address for correspondence if different
Telephone number / Home: ____________
Work: ______
Mobile: ______
Email
Are you an Irish/EU citizen? / □Yes □No
If you are not an Irish/EUcitizen, do you have a current work permit for the Republic of Ireland? / □Yes □No
Have you ever been convicted of any offence by a Court in Ireland or abroad?
If yes, please furnish full details of the offence in question, the Court, the date of the conviction and the penalty or sanction imposed. / □Yes □No
This post is subject to Garda Vetting. Do you authorize the Institute to conduct a background check via the Garda Control Vetting Unit (GCVU)? / □Yes □No
EDUCATION
Institutions(s) attended / From / To / Certificates awarded, subjects and grades
Academic Qualifications
Award / Awarding Body / Conferral date / Grades / Final Examination subjects & results
Other Qualifications, including Membership/Fellowships
Organisation / Category of membership – full, associate, student, etc / Date of award dd/mm/yy / Indicate how membership was achieved
Current employment
Employer’s name or title
Employer’s address
Nature of business
Employment Period
Position in organisation
Preceding employment
Employer’s name or title
Employer’s address
Nature of business
Employment period
Position in organisation
Functions & responsibilities
Reason for leaving
Prior employments
Employer / From / To / Position and functions / Reason for leaving
Details of other previous experience relevant to application.
This section should include a description of experience relevant to the criteria outlined in the job description.
Details of current remuneration package
Current Salary
Salary Scale / Point on Salary Scale: -
Allowances
Other benefits
Reason for seeking the position applied for
Period of Notice
How soon would you be available to take up the position if it were offered?
Additional information – any other information that may help in assessing your application.
Advertisement - how did you become aware of the position advertised?
ITB website □
National newspaper □ / Word of mouth □
Social Media □
Referees – the Institute will assume permission to contact referees to seek references and attendance records unless the applicant has stated otherwise. Please include current or most recent employer.
Name and address / Position / Contact
1st Referee / Ph:
Mobile:
E-mail:
2nd Referee / Ph:
Mobile:
E-mail:
3rd Referee / Ph:
Mobile:
E-mail:
Declaration
I hereby certify that I have read the Notes on Page 1 of this application form and that all statements given by me on this application form are true complete and correct.

Signature of Applicant: ______

Date: ______

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