Guidance Notes for Completion and Printing of the Application Form BR

Guidance notes for completion and printing of the Application Form BR

The Application Form BR should be completed using a computer only.
Handwritten forms will not be accepted or processed.
All relevant fields should be completed in full.
Text should not be altered from the standard ‘Times New Roman”, font size 12, as used in the body of the form.
Text must easily readable when printed. Addresses should be entered as at example 1 below. Entering text as at example 2 will result in your application form being returned to you for correction and may delay the processing of your application.

Example 1

Address 250 Harcourt Square
Harcourt Street
Dublin 2

Example 2

Address 250 Harcourt Sq, Harcouyrt
Dublin 2

The completed Application Form BR should be checked for spelling errors, prior to being printed.
The declaration at Section 16 should be the last text on the page of your Application Form BR.
The Cover Page (following page) and the Receipt for Application Form BR (at the end of this document) when printed, should each be on a separate page and should not encroach on the text from other pages. Under no circumstances should the receipt page be printed as part of the Application Form BR.
This page should not accompany your application.

Application Form – Garda Reserve (Form BR)

NOTES FOR APPLICANT

Please read these instructions before completing this form.

Allanswer fields are compulsory.

(a)Do not complete this form unless you have been advised by the Public Appointments Service that you have been successful at interview/written exam and unless you meet the statutory requirements as set out in the Notes for Candidates document on .

(b)Complete this form using a computer. Handwritten forms will not be processed.

(c)Question 1(e).State Country if born Outside Ireland / County if born in IrelandQuestion 1(f). State your role within Firm/Company.

(d)Questions 3 to 8:

All named persons must be accompanied by Date, Month and Year of Birth.

Exact Address in each case is required: House Number/Name as appropriate.

Relationship: State Uncle/Aunt/Brother/Sister as appropriate.

(c) Question 9(b). Refers to Irish Leaving Certificate Examination only. Candidates, who have undergone other examinations may specify same in Educational Exemption field(9(c)).

(d)Applicants should attach a recent passport size photo.

(e)When completed, forms must be submitted to your local Garda Station along with

the receipt attached.

(e)Application for selection as a member of the Garda Reserve is made on the understanding that the Commissioner of An Garda Síochána retains the right to reject any applicant without giving reasons.

(f)Failure to complete this form truthfully will result in rejection of the application.

Application Form – Garda Reserve (FormBR)

CANDIDATE:

(a)Surname:

(b)First Name:

(Surname and Forename(s) as shown on original Birth Certificate)

(c)Nationality: (d) D.O.B. Date Month Year

(e)Place of Birth:

(f)Present Occupation:

(g)PPS Number: (h) E-mail Address

(i)Present Address:

(j)Phone Numbers: (at present address)

(at work)(Contact Number)

(k)Home Address (if different from above):

(l)Give all former addresses (both permanent and temporary excluding above) from

birth and include approximate dates:

Address / From / To

2.Name of next-of-kin:

Address of next of kin:

Telephone number:

3.Candidate’s Father, Mother & Spouse/Partner:

Father / Mother / Spouse/Partner / N/A
(Please X appropriate box)
Surname / Nee / (nee)
First name
Date of Birth
Occupation
Nationality
Address

4.Dependents (including children):

Name / Address/Previous Address / D.O.B.

5.Brothers, Sisters, Half-Brothers, Half-Sisters of candidate (if any):

Surname / First name / Date of Birth / Occupation / Postal
Address / Relationship
to applicant

6.Other relatives (Uncles, Aunts):

Surname / First name / Date of Birth / Occupation / Postal
Address / Relationship
to applicant

7.Details of Candidate’s Spouse/Partner (if applicable):

Spouse’s/Partner’s Father / Spouse’s/Partner’s Mother
Surname: / Nee
First Name:
Date of Birth:
Place of Birth:
Occupation:
Nationality:
Address:

8.Spouse’s/Partner’s Brothers, Sisters, Uncles and Aunts (if applicable):

Surname / First name / Date of Birth / Occupation / Postal
Address / Relationship
to spouse/partner

9.Education and other Qualifications:

(a)Name in order, Schools, Colleges etc. you have attended:

Nameof School/College / Postal
Address / Year
From To / Age on
Leaving

(b)Leaving Certificate:Yes / No YEAR:

TYPE: Established / Vocational / Applied (Please X appropriate box)

Subject / Enter Grade Awarded / Subject / Enter Grade Awarded
Hon. / Pass / Other / Hon. / Pass / Other

(c)If you are seeking exemption from Educational Qualifications please give details:

(d)Degree / Diploma / Certificate / Other – Give Details

(e)Are you qualified in any other Trade / Profession?Yes/No

If “Yes” give details:

(f)Are you a native Irish speaker?Yes/No

(g)Include particulars of any other language(s) you speak, giving degree of fluency:

10.Particulars of Employment:

(a)State full name and address of your present employer,if applicable:

Name & Address / Capacity in which employed / Date commenced Employment

(b)State full name and address of all previous employers in the last 10 years including

Part-time employment in chronological order:

Name & Address / Capacity in which Employed / Dates employed / Reason for leaving
from / To

(c)Have you ever resigned, been dismissed or discharged from any employment?

Yes/No

If so, state when, cause and name of employer:

11. (a)Have you ever been the subject or involved in a Garda / Police investigation regardless of

outcome?Yes/No

If “Yes” give particulars:

(b)Have you ever been arrested / taken into Garda / Police custody regardless of outcome? Yes/No

If “Yes” give particulars:

(c)Have you ever been charged with a crime / offence:Yes/No

If “Yes”, give particulars:

(d)Have you ever been summonsed to appear in Court:Yes/No

If “Yes”, give particulars:

(e)Have you ever been convicted of a crime/offence by a Court or a Commanding Officer

of the Defence Forces? Yes/No

If “Yes”, give particulars:

(f)Is any charge or summons at present outstanding against you?Yes/No

If “Yes”, give particulars:

12.(a)Do you suffer from any disability or disease? Yes/No

If “Yes” give details:

(b)Are you taking on a regular basis any drugs or medication?Yes/No

If “Yes”, give particulars:

(c)Have you ever been hospitalised?Yes/No

If “Yes” give details:

(d)Have you ever suffered from any illness?Yes/No

If “Yes” give details:

You will be required to supply to a registered medical practitioner nominated by the Garda Commissioner a medical certificate in such form as that practitioner may determine, detailing your medical history for the previous 5 years.

13.List spare-time activities in which you have a recent interest and indicate your involvement,

giving names of any organisation or clubs of which you are currently a member:

14.General:

(a)Are you a member of any Political Party or Organisation?Yes/No

If “Yes” give full details:

(b)Did you ever previously apply for admission to An Garda Síochána? Yes/No If “Yes” give details, year, reference number(s) and stage attained, specifically stating

if your application was rejected by the Commissioner.

15.Reference:

(a)Give the name and Station of any member of An Garda Síochána known to you and who would be willing to recommend your application.

Name / Station

(b)Please provide a reference from your current employer and from one other person (not a member of An Garda Síochána and not related to you), who have known you for at least five years up to present date and who would be willing to recommend your application. Please list the 2 names / addresses / ages / occupation below:

Name / Address / Approx. Age / Occupation

(b)References are attached to print copy Yes/No

16.Declaration by Candidate:

I hereby declare that I fulfil all the requirements set-out in the Garda Síochána (Reserve Members) Regulations, 2006, that the information given in this form is correct and I hereby give my permission for enquiries to be made to establish such matters as age, qualifications, experience and character and for the release by other people or organisations of such information as may be necessary to An Garda Síochána for that purpose.

______

(Signature of Applicant witnessed by Garda Member)

Garda Witness:______Station: ______

Rank and Reg. No.______Date:______

Receipt for Garda Reserve Application Form BR.

(Original to be returned to the Candidate)

Name of candidate: ______

Garda Reserve Candidate Number:

Garda Station where form was submitted: ______

Date submitted:

Name of member witnessing Form BR(block capitals):______

Signature of member witnessing Form BR: _____

(see below)

The original Application Form BR should be retained by the Garda member witnessing the form and a report completed, prior to the form being forwarded to HRM.

The member witnessing the Application Form BR should post or fax a copy of this receipt immediately to:

Assistant Commissioner,

Human Resource Management,

(Garda Reserve Section)

Garda Headquarters,

Dublin 8.

Fax. 01-6662395

Tel. 01-6662568/70/71

NOTE:The Application Form BR should only be accepted from Applicants who have been advised by the Public Appointments Service that they have been successful at the interview/written test. Forms should not be accepted from unsuccessful Applicants.