APPLICATION FORM
For office based staff
REFJ289
POSTSenior Administrative Officer
Please read carefully through the Guidance Notes before completing this form.
Title: / First Name: / Surname:Address:
Postcode:
Home Telephone: / Work Telephone:
Email address:
National Insurance Number:
Do you have a clean driving licence?YES NO
Do you own or have access to a car which is available for business use? YES NO
Are you able to fulfil the travel requirements of the post?YES NO
Do you require a permit/visa to work in the UK? YES NO
If you require a permit/visa, do you possess one?YES NO
If yes above, please state the start/end dates of permit/visa and any restrictions which apply:
If you require a permit/visa and do not possess one, please explain why:
Do you have a disability which you consider relevant to your Application?YES NO
If YES above, is there anything we need to know in order to offer you a fair selection interview?
Academic Qualifications and Courses - highest level qualification(s) first
Qualification / Subject / Grade / DateProfessional qualifications
Qualification / Degree of membership / DateCurrent or most recent employment
Job title: / Company:Address:
Telephone: / From (date): To (date):
Salary (including bonuses): / Notice required:
Number of days absent due to illness: last 12 months previous 12 months
Responsibilities and main duties:
Reason for leaving / wishing to leave:
Previous employment (last two posts)
Please include periods of unemployment, unpaid placements and voluntary work.
Name and address of employer:Job title: / From: / To:
Responsibilities and main duties:
Name and address of employer:
Job title: / From: / To:
Responsibilities and main duties:
Suitability for post- Ensure your refer closely to the Job Description / Person Specification Please demonstrate how you meet all the Essential Criteria for this post.
Max. 800 words. Continue overleaf if needed.Again, referring closely to the Job Description / Person Specification
Please demonstrate to what extent you meet some or all theDesirable Criteria for this post.
Max. 400 words.Additional questions and notes
Are there any health reason which will affect your ability to undertake the duties of this post?
YES NO If YES:
Are you the subject of any police enquiry or do you have a prosecution pending?
YES NO If YES:
Have you ever been convicted of a criminal offence?
YES NO If YES:
Has your partner ever been convicted of a criminal offence? (Residential / care posts only)
YES NO If YES:
Are you related to any Habinteg employee or Board Member?
YES NO If YES:
Are you a previous Habinteg employee?
YES NO If YES:
If selected for the post:
You will be required to complete a medical questionnaire and/or medical check.
An AccessNI check may be required, dependent upon the nature of the post.
If you are offered accommodation as part of an offer of employment:
Habinteg will advise your present landlord (if NIHE or another housing association).
References:
Please supply three referees. The first should be your current / most recent employer.
Referees should not be related to you and are contactable without further contact with you.
1. Name: / Occupation:Address:
Telephone: / Email:
2. Name: / Occupation:
Address:
Telephone: / Email:
3. Name: / Occupation:
Address:
Telephone: / Email:
May we contact referee 1 (current/recent employer) prior to interview? YES NO
Declaration of applicant
I declare that, to the best of my knowledge, the information supplied in this application form is true and accurate. I understand that false information, or the omission of material information, could lead to disqualification or termination of any subsequent contract of employment. I understand that the information given by me on this form will be processed in accordance with Data Protection Legislation.
SIGNATURE DATE
To help us monitor the effectiveness of our advertising, please indicate where you saw this position advertised
Belfast Telegraph Sunday Life Job Centre NIFHA website Habinteg website
Or other, please specify
PLEASE READ CAREFULLY THROUGH YOUR APPLICATION FORM TO ENSURE THAT YOU HAVE ANSWERED ALL SECTIONS CORRECTLY. CAREFULLY READ THROUGH THE GUIDANCE NOTES AND MAKE SURE YOU ALLOW ENOUGH TIME FOR DELIVERY TO MEET THE DEADLINE. IF POSTING YOUR APPLICATION, THE MONITORING FORM WHICH FOLLOWS MUST BE PLACED IN A SEALED ENVELOPE MARKED MONITORING FORM AND INCLUDED ALONG WITH YOUR APPLICATION.
PRIVATE & CONFIDENTIAL
MONITORING FORM
MON. No:Click here to enter text.(applicant leave blank - office use)
REF No:Click here to enter text.
Habinteg Housing Association (Ulster) Ltd monitors the applicants it receives for jobs in order to ensure that its recruitment practices promote equality of opportunity.
This information will be treated in the strictest confidence and protected from misuse. It will be separated from your Application Form and will not form any part of the selection process. There are two pages of Monitoring Information. To protect your privacy, you should not write your name on the form, a number added above will be the only link with your Application Form and will be known only to the Monitoring Officer.
You are not obliged to answer these monitoring questions and you will not suffer any penalty if you choose not to do so. We do, however, encourage you to answer and please note that it is a criminal offence under the legislation for a person to knowingly give false information under the Fair Employment (Monitoring) Regulations (NI) 1999.
FAIR EMPLOYMENT MONITORING QUESTIONNAIRE
We monitor the community background and sex of our job applicants in order to demonstrate our commitment to promoting equality and to comply with our duties under the Fair Employment and Treatment (NI) Order 1998. Please complete and tick as appropriate.
Community Background
I am a member of the Protestant Community
I am a member of the Roman Catholic Community
I am not a member of the Protestant or Roman Catholic communities
Sex
Male
Female
EQUAL OPPORTUNITIES MONITORING QUESTIONNAIRE
We are an Equal Opportunities Employer. We aim to provide equality of opportunity to all persons regardless of their religious belief; political opinion; sex; race; age; sexual orientation; whether they married or in a civil partnership; whether disabled; whether undergone, undergoing or intend to undergo gender reassignment. We do not discriminate against job applicants on any of these grounds.
Age
Date of birth:
Marital status / civil partnership
Are you married or in a civil partnership?YES NO
Political opinion
Unionist Nationalist Neither
Disability
Under the Disability Discrimination Act 1995 a person is deemed to be a disabled person if he or she has a physical or mental impairment which has a substantial and long term adverse effect on his or her ability to carry out normal day-to-day activities.
Do you consider that you are a disabled person?YES NO
If YES, please indicate the nature of the disability:
Racial Group
Please state your country of birth:
Please state your nationality:
Please indicate your race or colour or ethnic or national origins:
WhiteChinese Irish Traveller Indian
Pakistani BangladeshiBlack Caribbean Black African Black other Mixed ethnic group (please state which):
Any other ethnic group (please state which):
Dependants / Caring responsibilities
Do you have dependents, or caring responsibility for family members or other persons?YES NO
If ‘yes’ please indicate whether your dependents or the people you look after are:
A child or children Disabled person(s) Elderly person(s) Other
If ‘other’ please specify:
Sexual Orientation
Please indicate your sexual orientation:
I am straight I am gay or lesbian I am bisexual
If you are sending a hard copy / handwritten application, please place this completed Monitoring information in an envelope marked Monitoring Form and place inside your postal envelope along with your Application Form.
If emailing your Application, this completed Monitoring Form will be separated from your Application by the Monitoring Officer and will not form part of the recruitment process.
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