Surname
/ First Given Names /Position
/ EUCAPA Coordinator/ CARA Adapted Physical Activity Centre Ltd
ITT South Campus, Tralee, Co. Kerry Tel. 066- 714 5646
Email: Website: www.caraapacentre.ie /PLEASE READ CAREFULLY THE INSTRUCTIONS GIVEN BELOW
§ Complete all sections of this form carefully, in black ink or typeface
§ Do not leave any section of this form blank
§ You may submit a CV along with the application form
§ Do not refer to a CV for critical information on qualifications or experience
§ Ensure all academic qualifications are accurately and clearly stated
§ Any queries to: Niamh Daffy: 0667145646/
§ Return completed form to:
Niamh Daffy- National Manager
CARA Adapted Physical Activity Centre
ITT South CampusTralee
Co Kerry, Ireland
to arrive not later than
12.00 noon on Wednesday 6th July 2011
NOTE: Applications received after the closing date will not be accepted
Screening and shortlisting will take place on the basis of information presented on this application form only.
1.
/ APPLICATION FOR THE POST OF: /EUCAPA Conference Coordinator
1.2
/ SURNAME: / /GIVEN NAMES:
// /
BLOCK CAPITALS PLEASE
/ /FULL NAME PLEASE
1.3
/ADDRESS:
/1.4 /
CONTACT INFORMATION
/ / /TELEPHONE NUMBERS
/( )
/MOBILE
/(DAY)
/Area Code Tel No
/ /If Available
(EVENING)
/( )
/FAX NUMBER
//
Area Code Tel No
/ /If Available
EMAIL ADDRESS
/ / /If Available
/ /2
/SECOND LEVEL EDUCATION
/ / //
SCHOOL NAME
/ /FROM:
/ /TO:
// ADDRESS / / /
3. /
THIRD LEVEL QUALIFICATIONS – (HETAC/NCEA, PROFESSIONAL OR UNIVERSITY ACCREDITED ETC) – (use additional sheet if necessary)
3.1 / NAME OF THIRD LEVEL INSTITUTION ATTENDED:ADDRESS:
STUDIED FROM: / STUDIED TO:
TITLE / GRADE / AWARDED BY / CONFERRED
MONTH/YEAR
FINAL YEAR SUBJECTS:
3.2 / NAME OF THIRD LEVEL INSTITUTION ATTENDED:
ADDRESS:
STUDIED FROM: / STUDIED TO:
TITLE / GRADE / AWARDED BY / CONFERRED
MONTH/YEAR
FINAL YEAR SUBJECTS:
4 / LIST RELEVANT COURSES/SEMINARS ATTENDED WITH DATES, DURATION AND EFFECTIVENES
5 / PLEASE OUTLINE IN DETAIL YOUR EXPERIENCE/FAMILIARITY WITH COMPUTER PACKAGES/SYSTEMS/APPLICATIONS
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/ Employment : Please state in order of most recent employment. As the information given in this section is used for screening / shortlisting please give full details of your past employments, leaving no gaps. If currently, or in the past you were not in employment, please state so. Do not refer to a CV. If there is insufficient space on this page, please give further details on a continuation sheet, using the same format.7.1
/ EMPLOYMENTS Please state in order of most recent employmentPOSITION HELD:
Total Number of Months
FROM (Month & Year) / TO (Month & Year)
BRIEF DESCRIPTION OF DUTIES:
REASON(S) FOR LEAVING
7.2
/ EMPLOYMENTSPOSITION HELD:
Total Number of Months
FROM (Month & Year) / TO (Month & Year)
BRIEF DESCRIPTION OF DUTIES:
REASON(S) FOR LEAVING
7.3
/ EMPLOYMENTSPOSITION HELD:
Total Number of Months
FROM (Month & Year) / TO (Month & Year)
BRIEF DESCRIPTION OF DUTIES:
REASON(S) FOR LEAVING
7.4
/ EMPLOYMENTSPOSITION HELD:
Total Number of Months
FROM (Month & Year) / TO (Month & Year)
BRIEF DESCRIPTION OF DUTIES:
REASON(S) FOR LEAVING
7.6
/ EMPLOYMENTSPOSITION HELD:
Total Number of Months
FROM (Month & Year) / TO (Month & Year)
BRIEF DESCRIPTION OF DUTIES:
REASON(S) FOR LEAVING
8.
/ PLEASE PROVIDE DETAILS OF EXPERIENCE IN EVENT MANAGEMENT AND/OR COORDINATION9
/ OTHER RELEVANT INFORMATION IN SUPPORT OF YOUR APPLICATION:10 / REFEREES:
(Please note that three referees must be given)
10.1 / MUST BE FROM CURRENT EMPLOYMENTNAME OF REFEREE: / PERMISSION TO CONTACT / YES / NO
BUSINESS ADDRESS:
TELEPHONE NUMBER:
POSITION HELD IN ORGANISATION:
10.2 / MUST BE FROM EMPLOYMENT OTHER THAN CURRENT EMPLOYMENT
NAME OF REFEREE: / PERMISSION TO CONTACT / YES / NO
BUSINESS ADDRESS:
TELEPHONE NUMBER:
POSITION HELD IN ORGANISATION:
10.3 / OTHER REFEREE
NAME OF REFEREE: / PERMISSION TO CONTACT / YES / NO
BUSINESS ADDRESS:
TELEPHONE NUMBER:
POSITION HELD IN ORGANISATION:
YES / NO
11. Do you hold a full drivers licience?
12. Licence Type: ______
13.
/ DECLARATION/ Any applicant who canvasses or seeks to canvass (by himself / herself or through a third party) any member of the Selection Board in support of his/her candidature shall be disqualified by the Selection Board. Thus I fully recognise that canvassing will disqualify my application.
I hereby certify that all statements given by me in this application form or in correspondence or interview are true and correct and without omission. I accept that any mis-statement or material omission from this form will disqualify my application and invalidate any offer of employment.
SIGNATURE OF APPLICANT / DATE
Where did you hear about this position?
CARA Website 1
Local Sports Partnership Newsletter/Website 1
NGB Website 1
Other, Please Specify ______1
Please Note: Closing Date: 12.00 Noon on Wednesday 6th July. Applications received after the closing date will not be accepted
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