Position Applied For: Domestic Violence Support Worker (Refuge)

Position Applied For: Domestic Violence Support Worker (Refuge)

OMAGH WOMEN’S AID

Application Form Ref. No: 05/17

Position Applied For: Domestic Violence Support Worker (Refuge)

Closing Date: no later than Friday 18th August 2017 @ 12 noon

Omagh Women’s Aid is an equal opportunities employer and welcomes applications from everyone from all sections of the community who meets the criteria for the post.

Please read the notesbelow before completing the application form:

  • Complete in black ink or typescript only
  • Use font no smaller than point 10
  • Do not alter the formatting of the form
  • Abide by word limits where applicable

** Please note Interviews are scheduled for Thursday 31st August 2017 and candidates selected for interview will be contacted using the contact details provided in this form **

Return completed form to:

The Administrative Assistant, Omagh Women’s Aid, 27 Market St, Omagh, BT78 1EL

or email

For Official Use Only

Date Application received______

Confidential

Position applied for: Refuge Based Domestic Violence Support Worker

Personal Details

Surname:j / Forenames:
Preferred Title:
Home Address:
E mail:
Telephone: Day Evening:
If successful, when could you take up the appointment:

References

Please give details of three people whom we may contact for a reference. References will be taken up if you are successful at interview and any offer of employment made will be subject to references being satisfactory. At least 2 referees should have knowledge of you in a working environment, either paid or unpaid, and one must be your current/last employer. If you are a recent school/college leaver please give appropriate school/college referees.

Name / E mail Address / Telephone / Occupation / State your relationship with the referee

Education. Continue on another sheet if necessary

Name and address of Schools/University / Recognised Qualifications and Grades

Paid Employment

Please start with your present employment and work backwards. Continue on another sheet if necessary. Do not list work placements undertaken as part of a course of study or undertaken as part of gaining a qualification in this section.

Employers Name and address / Job Title / Full/Part-Time
No. hrs p/wk / Dates of employment and total length of service / Reason for leaving

Work Placements

Please list any work placements/experience of more than six weeks duration undertaken in the last five years

Dates of placement / Name and address of Placement Organisation / Role undertaken in Placement

Voluntary Work

Include details of any unpaid/voluntary work

Dates From/To / Name and Address of Organisation / Nature of Work / Hrs Per Week

Leisure Activities (200 words max)

(Sports, hobbies etc)

Training and Skills

Please give details of any external or internal courses or training within the last five years

Date / Course Title / Length of Course

Office Skills

Word –processing
(100 max)
Powerpoint
(100 max)
General computer skills/ IT Packages (100 max)

Driving Ability

Do you hold a full current UK Driving LicenceYES/NO

Do you have access to a carYES/NO

Disclosure of Convictions

  1. Have you been convicted of any motor offences resulting in disqualifications? YES/NO
  1. Please give details of accidents within last 3 years, endorsements etc
  1. Have you ever been convicted of any offence, which is not considered spent?YES/NO

If the answer is ‘yes’ please give details on a separate sheet.

Medical History

Please provide details of recurring illness or medical problems for which you are receiving attention or medication.

Periods of Absence

Please give details of any illness, operation or accident resulting in an absence from work, paid or unpaid within the last 2 years.

Illness, operation or accident / Dates / No. of days absent

Please list other periods of absence and reason for absence (e.g. caring for dependents, exceptional leave, compassionate leave) within the last 2 years.

Reason for absence / Dates / No. of days absent

Information in Support of your Application – You may use additional sheets if necessary. Tell us how you meet each of the following criteria and the extent of your experience in each category.

One + year full-time experience of working in a supportive role within residential or community based environment.
(200 words max)
Experience of working with statutory and voluntary sector agencies.
(200 words max)
Experience of needs and risk assessment and support planning.
(200 words max)
Experience of working with service users with complex needs.
(200 words max)
Experience of working with service users in crisis.
(200 words max)
Experience of crisis handling
(200 words max)

Please tell us how you meet the following criteria.

Training Skills
(150 words max)
Presentation Skills
(150 words max)
Group facilitation skills
(150 words max)
Knowledge of legislation relating to domestic violence, protection and justice, support and safeguarding
(150 words max)
Experience of working with children and young people
(150 words max)

Declaration

I certify that all the particulars given are correct and understand that should any false statements/omissions be made on this form Omagh Women’s Aid reserves the right of dismissal. I understand that employment with Omagh Women’s Aid is subject to receipt of satisfactory references.

Signature of Applicant (Write or Type):

Date:

We aim to be FAIR Employers. We do not discriminate on the grounds of religion, marital status, disability, race or ethnic origin. We practice equality of opportunity in employment and most importantly, have a firm belief in the MERIT principle (i.e. the best person for the post)

We want to demonstrate this commitment and to do so; we need to monitor certain details of our applicants.

We are, therefore, asking you to give us extra information, which will be treated in the strictest of confidence and used for monitoring purposes only. This extra form will not be filed with your other details, as given on your application form.

We would therefore ask you to complete the attached form. Thank you for your co-operation in this matter.

OMAGH WOMEN’S AID

Ref:

Community based Domestic Violence Support Worker

STRICTLY CONFIDENTIAL

SECTION A:

Please indicate the community to which you perceive yourself belonging by writing yes beside the appropriate statement below:

  1. I perceive myself to be from the Protestant community
  2. I perceive myself to be from the Roman Catholic community
  3. I perceive myself to be from neither the Protestant nor the Roman Catholic community

SECTION C:

Date of Birth.

It is not compulsory for you to answer the above questions. However, I would stress that it is a criminal offence under the legislation for a person to “give false information in connection with the preparation of a monitoring return.

Job Application Form –Refuge Based Domestic Violence Support Worker August 20171

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