Strictly Confidential

Drogheda Homeless Aid Association Ltd.

Application Form (Please complete in own handwriting)

Position of ReliefTeam Leader

Section 1Personal Details

(A)Name

(B)Address

(C)Telephone no.:

Home:Work:Mobile:

(D)Email Address: ______

Section 2Educational Record

A) Please give details of schools / institutes / universities attended

Qualifications / Grade /
Dates
/ College /
Awarding body / Core Subjects

B) Please detail other training courses attended

Date / Course Details / Training Body / Core Subjects

Section 3Employment History

(A)Particulars of present or last employment:

Employer

Address

Date of Appointment

Commencing Salary

Present Salary

Position / Title

Describe the nature of your duties and the extent of your authority / responsibility:

What period of notice are you required to give?

(B)All Positions / Employment

Dates
(Starting with the most recent) /

Employer

/ Position Held (including main duties) / Reason for Leaving

(C) Please outline your understanding of homelessness, the reason why people become homeless and the barriers that may obstruct people from returning to independent living:

(D) Based on your experiences to date, please outline why you feel that you are qualified to fill this position:

(E)Please indicate your reasons for seeking this position:

Section 4

Any other information that may help in assessing your application. Voluntary activities and interests may be included here.

Section 5 Referees

Please provide two referees – one of whom should be your present or most recent employer. The other should be someone who has known you in work, education, or a voluntary organisation. All appointments are subject to satisfactory references. These referees will not be contacted without your prior permission.

Name

Position

Organisation

Address

Tel no.

Name

Position

Organisation

Address

Tel no.

Garda Clearance

Garda Clearance is required for this position.

Convictions

Have you any convictions: YesNo

If yes, please detail:

Are there any restrictions on your right to work in Ireland?Yes No

If yes, please give details:

Declaration

I declare that the information in this document is, to the best of my knowledge, true in every detail. I declare that I have filled in this application form myself in my own handwriting. I understand that false statements may lead to disqualification, or if appointed, to termination of employment.

Signed: Date:

Drogheda Homeless Aid is an equal opportunities employer.

Please return by email or by post,

marked private and confidential, to:

Mr Raymond Hughes

Staff Supervisor

Drogheda Homeless Aid

35 North Strand

Drogheda

By 5.00pm on Tuesday 17th April 2018.

1

Please note: Applicants must fill in this application form in their own handwriting.