Part B - Qualifications and Experience

Job Reference: / EOII/05/16
Applicant No:

An Equal Opportunities Employer

Applicants should refer to the Information for Applicants and the Job Description & Person Specification before completing this form. The Equal Opportunities Monitoring Form MUST also be completed.
Please complete the form in TYPESCRIPT or CAPITAL LETTERS and BLACK INK. Applications can be sent in hard copy or by e-mail and MUST be marked Private and Confidential. Please see the Information for Applicants Booklet for details.
Applicants MUST complete all sections and sign the form either in person if hard copy or, if emailing your form, by typing your name under the section entitled ‘Declaration’.
Completed signed applicationsMUST arrive no later than Friday,7th October 2016 at 16:00.

PART A - PERSONAL DETAILS

Personal Details
Surname:
Click here to enter text. / Forename(s):
Click here to enter text. / Previous Surname (if applicable):
Click here to enter text. / Mr/Mrs/Miss/Ms/Dr
Click here to enter text.
Address:
Click here to enter text.
Postcode:Click here to enter text. / Contact Telephone Numbers:
Telephone:Click here to enter text.
Mobile:Click here to enter text.
Are you eligible to work in the UK?
The Agency will require proof of this right before an offer of employment can be confirmed e.g. birth certificate and/or any other appropriate documentation required to confirm your right to work in the UK as required by the Asylum and Immigration Act 1996. / Yes
☐ / No
☐
National Insurance Number:Click here to enter text.
Availability for Interview
Please detail dates on which you would be unavailable for interview. Where possible these will be avoided.
Click here to enter text.
Notice Requirement
If appointed, please indicate the earliest date on which you could take up employment with the Agency.
Click here to enter text.
References:
Please provide details of two referees one of whom must be your present/most recent employer. Please provide at least two means of contacting your referees. We will not contact the named persons until after we have offered you the job for which you have applied.
Name:
Click here to enter text. / Name:
Click here to enter text.
Address:
Click here to enter text. / Address:
Click here to enter text.
Job Title:
Click here to enter text. / Job Title:
Click here to enter text.
Tel No: Click here to enter text.
E-mail: Click here to enter text. / Tel No: Click here to enter text.
E-mail: Click here to enter text.
Declaration:
The particulars given by me in this application are true and accurate to the best of my knowledge and belief.I understand that a candidate found to have given false information or wilfully to have suppressed any material fact will be liable to either disqualification or, if appointed, to dismissal.
Signed:Click here to enter text. / Date:Click here to enter text.
Please indicate which pattern(/s) you are interested in working:
Note that preferences cannot be altered once an application has been submitted.
Job share/part-time only ☐
Full-time only ☐
Full-time/job share/part-time ☐
Please now complete Part B of the Application Form.

PART B - QUALIFICATIONS AND EXPERIENCE

The information in Part B will be provided to the Shortlisting and Interview Panel.
Before you submit your application, please ensure your eligibility for this competition by referring to the Job Description and Person Specification. Please ensure that you provide sufficient information on this form to enable the short listing panel to assess your eligibility for interview.
With respect to qualifications, you need only complete those sections that provide the information to demonstrate that you satisfy the essential and desirable criteria.
Certificates should not be submitted with this application. Successful candidates will be asked to provide original certificates (not copies).
Qualifications (GCSEs, RSA, NVQ, A Levels etc)
Subject obtained/to be taken
e.g. English Language / Level
e.g. GCSE / Examining Body
e.g. CCEA / Grade / Year obtained/expected
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Further Education (University or College)
First third level qualification
Name of institution / Dates attended / Title of qualification / Specify if a degree, diploma or certificate (include class and division) / Main subjects / Date Awarded/ expected
Click here to enter text. / Click here to enter text. / Click here to enter text. / Click here to enter text. / Click here to enter text. / Click here to enter text. /
Postgraduate Qualification
Name of institution / Dates attended / Title of qualification / Specify if a degree, diploma or certificate (include by study or research) / Main subjects / Date Awarded/ expected
Click here to enter text. / Click here to enter text. / Click here to enter text. / Click here to enter text. / Click here to enter text. / Click here to enter text. /
Professional/Vocational Qualifications and Membership
Professional/Vocational Qualification obtained / Date
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Professional bodies of which you are a member / Membership Grade
Click here to enter text. / Click here to enter text. /
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Career History
Please detail below all your employment/self-employment/voluntary work relevant to this application. Start with your present/most recent employer/organisation.
Name & Address of most recent employer/organisation / Job Title Grade/Position / Current Salary/salary on leaving(if applicable) / From / To
Month / Year / Month / Year
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Main Duties and Responsibilities
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Previous Experience
Please list below all other employment/self-employment/voluntary work relevant to this application. (Continue on a blank page if necessary and please add your initials).
Employer/Organisation / Job Title /Grade/Position / Main Duties & Responsibilities / From / To
Month / Year / Month / Year
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Qualifications, Experience and Competencies
Please refer to the Person Specification and Information for Applicants Booklet
Please use the space provided and if you use additional sheets, please initial these and make it clear to which section they refer.
Please complete ALL sections succinctly and in full. Incomplete applications will NOT be progressed.
FAILURE TO SUFFICIENTLY INCLUDE ALL RELEVANT INFORMATION IN A SECTION WILL NOT BE MITIGATED BY PLACING SUCH INFORMATION ELSEWHERE IN THE APPLICATION FORM.
Please refer to the Person Specification. It is essential that you fully describe how you meet the particular experience and competency sought, giving clear examples and specifying exact dates where required. It is not appropriate to simply list the various posts that you have held. No assumptions will be made from the title of the post as to the skills and experience you have gained.
The Agency may decide to interview only those applicants who the panel deem to be the most suitable in terms of relevant experience and ability. This decision will be based on the information you provide in the application form.
ESSENTIAL CRITERIA – QUALIFICATIONS
Please refer to the Person Specification and Information for Applicants Bookletbefore completing this section. (Qualifications must be held on the closing date).

1.1Do you have the Qualifications as defined below?

Academic Qualifications Route – A minimum of 4 GCSEs which must include English and Maths at Grade C or above or equivalent.
(Applications through this route should demonstrate a minimum of one year’s experience as at 1.3 below).
☐Yes ☐No
If “Yes” enter the qualification below in line with the Person Specification. If “No” please proceed to 1.2 below.
Please include the qualification title(/s), year of completion, level and mark/grade:
Click here to enter text.
1.2 I confirm I do not hold the qualification or equivalent qualification per section 1.1 above and the Person Specification and will be applying based on THREE years’ experience.
☐Please check the box to confirm the above.
ESSENTIAL CRITERIA – EXPERIENCE
Please refer to the Person Specification and Information for Applicants before completing this section.
Please include dates (e.g. from 01/01/2001 to 31/12/2002) as failure to do so will result in your application not being shortlisted.
Applicants are reminded that if they are applying supported by the relevant qualifications (1.1) they require to demonstrate a minimum of one years’ relevant experience as at 1.3 below whereasthose without the relevant qualifications (1.2) are required to demonstrate a minimum of three years’ relevant experience as at 1.3 below.
1.3The relevant duration (referring to 1.1 or 1.2 above):
a)supervisory experience within an office environment OR;
b)experience working in an employment relations, trade union or human resource environment.
a)the relevant duration (referring to 1.1 or 1.2 above) supervisory experience within an office environment OR;
Click here to enter text.
b)the relevant duration (referring to 1.1 or 1.2 above) experience working in an employment relations, or trade union, or human resource environment.
Click here to enter text.

As stated in the person specification applicants need only meet 1.3 a. OR 1.3 b. You may wish to enter information under sections 1.3 a. AND b. if you feel you meet both criteria. If both sections are completed the panel will consider part 1.3 a. first. If you meet 1.3 a, 1.3 b will NOT be considered by the panel. If you have competed both sections and are not short listed under section a. the panel will move to part b. and will consider whether you meet part b.

COMPETENCIES DEPLOYABLE IN THE SHORT LISTING PROCESS
A full list of the Agency’s competencies is set out in Section 2 of the Person Specification. All of these will be relevant at the interview stage.
In the event of a high number of applicants the Agency reserves the right to further shortlist by deploying four of the Agency’s nine competencies as below.
In the boxes below, please illustrate how you have demonstrated these competencies in your past experience. You should clearly identify your role and contribution in each case.
Role Knowledge:
Please give an example ofwhen you have applied your role knowledge to resolve a workplace-related issue (Limit 500 Words):
Click here to enter text.
Customer Focus
Please give an example ofwhen you have resolved a complex customer query to their satisfaction (Limit 500 Words):
Click here to enter text.
Communication:
Please give an example ofwhen you communicated a complex issue to a non-specialist to ensure their full understanding (Limit 500 Words):
Click here to enter text.
Working Relationships:
Please give an example ofwhen you contributed to a team exercise or project that had a successful outcome (Limit 500 Words):
Click here to enter text.
PART C–EQUAL OPPORTUNITIES MONITORING
The information in Part C will NOT be provided to the Shortlisting and Interview Panel.

EQUAL OPPORTUNITIES MONITORING FORM

PLEASE ENSURE THAT YOU COMPLETE THIS EQUAL OPPORTUNITIES MONITORING FORM
Access to this information will be strictly controlled and will not be available to those considering your application for employment. Monitoring will involve the use of statistical summaries of information in which the identities of individuals will not appear. The information will not be available for any purpose other than equal opportunities monitoring.
The Agency is fully committed to supporting the elimination of all forms of discrimination in employment and to using its services to help secure the objectives of fair employment, equality of opportunity and good relations. As a provider of services, the Agency includes equality of treatment as a fundamental principle of good employment relations and best employment practices. As an employer, the Agency seeks to ensure that its employment policies, procedures and practices conform to good practices as outlined in the relevant Codes of Practice.
The Agency selects those suitable for employment solely on the basis of merit without regard to an individual’s religious belief, gender, disability, race, political opinion, age, marital status, sexual orientation or whether or not they have dependants.
DATE OF BIRTH / Click here to enter text.
Please tick the appropriate box
GENDER
Are you / Male / ☐ / Female / ☐
MARITAL STATUS
Are you / Married / ☐ / Single / ☐ / Divorced / ☐ / Separated / ☐ / Other / ☐
HAVE YOU ANY CARING RESPONSIBILITY?
Children / ☐ / Relatives / ☐ / Other / ☐ / None / ☐ /
COMMUNITY BACKGROUND
The Fair Employment and Treatment (Northern Ireland) Order 1998 outlaws discrimination on the basis of religious belief or political opinion. The information below is required in connection with the requirements of the above Order. The use and confidentiality of Community Background information is protected by the Fair Employment and Treatment (Northern Ireland) Order 1998. It will be used only for monitoring the effectiveness of the Agency’s Equal opportunities Policy and to comply with obligations relating to monitoring, investigations or proceedings under the requirements of the Fair Employment and Treatment (Northern Ireland) Order 1998.
I have a Protestant community background / ☐ /
I have a Roman Catholic community background / ☐ /
I have neither a Protestant nor a Roman Catholic background / ☐ /

PLEASE ALSO COMPLETE THE PAGE OVERLEAF

RACE
The Race Relations (Northern Ireland) Order 1997 makes it unlawful to discriminate in employment on grounds of colour, race, nationality or ethnic or national origins. The Labour Relations Agency monitors its workforce in line with recommended good practice.
Please tick appropriate box
Are you
White / ☐ / of Black African origin / ☐ /
of Black Caribbean origin / ☐ / of Bangladeshi origin / ☐ /
of Chinese origin / ☐ / of Indian origin / ☐ /
of Pakistani origin / ☐ / of Other origin (please specify) / ☐ /
Are you a member of a mixed ethnic group? / YES / ☐ / NO / ☐ /
Are you a member of the Irish Traveller Community? / YES / ☐ / NO / ☐ /
DISABILITY (Please refer to the Guidance in the Information for Applicants Booklet before completing this section of the Monitoring Form)
The Disability Discrimination Act 1995 makes it unlawful for an employer to treat a disabled person less favourably than someone else because of their disability, unless there is good reason.
Under the Disability Discrimination Act 1995, disability is defined as:
“A physical or mental impairment which has a substantial and long-term effect on a person’s ability to carry out normal day-to-day activities”.
Using this definition do you consider yourself to have a disability? / YES / ☐ / NO / ☐ /
If you have answered “No” please ignore the remaining questions in this section.
If you have answered “Yes” please complete the remaining section by ticking the most appropriate category/ies.
Hearing Impairment / ☐ / Reduced Physical Capacity / ☐ /
Visual Impairment / ☐ / Severe Disfigurement / ☐ /
Speech Impairment / ☐ / Learning Difficulties / ☐ /
Mobility Impairment / ☐ / Mental Illness/Mental Health Difficulty / ☐ /
Physical Co-ordination Difficulties / ☐ / Other / ☐ /

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