APPLICATION FORM

POST OF WHOLE TIME STATION OFFICER.

This Application Form, when completed, should be returned to the Human Resources Officer, Human Resources Dept., Mayo County Council, Aras an Chontae, The Mall, Castlebar, so as to arrive no later than 4 p.m. on Thursday,21stApril, 2011.

(1)FULL NAME:______

(2)ADDRESS:______

______

______

______

______

(3)CONTACT DETAILS:Tel. No. Work: ______Home: ______

E-Mail Address: ______

(4)PRESENT EMPLOYER:______

______

______

______

(5) STANDARD OF EDUCATION:

School or college attended / Period / Examination Taken / Result
(Pass or Honours)

Where applicable, please submit copy of all results with application.

(6)ACCADEMIC, PROFESSIONAL OR TECHNICAL QUALIFICATIONS (if any)

Degree or other qualification held / By what body was qualification conferred / Date qualification was awarded / Major subjects taken / Other particulars

Where applicable, please submit copy of degree/qualification with application.

(7)CLASS OF DRIVING LICENCE B CEB

(Please circle appropriate class)

(8)EXPERIENCE AS

DRIVER:______

______

______

______

______

Please attach a photocopy of your full driving licence with this form

(9)STATE WHETHER YOU HAVE, AS A DRIVER,EVER BEEN INVOLVED IN ANY MOTOR ACCIDENT:

YES / NO (Please delete as appropriate)

If yes, please give details on separate page.

(10)STATE WHETHER YOUR DRIVING LICENCE HAS EVER BEEN SUSPENDED

OF ENDORSED:

YES / NO (Please delete as appropriate)

If yes, please give details on separate page.

(11)PARTICULARS OF TRAINING & EXPERIENCE INCLUDING FIRE BRIGADE COURSES SUCESSFULLY COMPLETED:

Course details / Training Centre / Date of course

Please indicate clearly if your qualification was achieved on second or subsequent attempts.

(12)OTHER TECHNICAL QUALIFICATIONS (TRADE CERTS, ETC) OR ANY SPECIAL

TRAINING OR EXPERIENCE IN THE DUTIES OF THE POST.

______

______

______

(13)GIVE NAMES AND ADDRESSES OF TWO RESPONSIBLE PERSONS TO WHOM ENQUIRIES MAY BE ADDRESSED REGARDING YOUR CHARACTER AND GENERAL SUITABLITY FOR APPOINTMENT. YOU SHOULD BE WELL KNOWN TO THESE PERSONS BUT NOT RELATED.

(a)______(b)______

______

______

______

(14)DOCUMENTS TO BE ATTACHED TO APLLICATION :-

(a) CERTIFICATE OF SERVICE IN (IF ANY) DEFENCE FORCES, AUXILLARY DEFENCE SERVICES OR ATTENDANCE AT SPECIAL TRAINING.

(b)CERTIFICATES, IF ANY, GIVING PARTICULARS OF ANY SPECIAL TRAINING OR QUALIFICATIONS IN THE DUTIES PERTAINING TO THE POST.

(c)PHOTOCOPY OF FULL DRIVING LICENCE AND ANY OTHER PROVISIONAL DRIVING LICENCE OR OTHER DRIVING QUALIFICATION.

Before signing this form, please ensure that you have replied fully to all questions asked. You should also satisfy yourself that you are eligible under the regulations. The Council cannot undertake to investigate the eligibility of candidates in advance of the interview, and hence persons who are ineligible but nevertheless enter may thus put themselves to unnecessary expense.

I, the undersigned, HEREBY DECLARE all the foregoing particulars to be true and give my permission for any enquiries to be made to establish such matters as qualifications, experience character and for the release by other people, agencies, police authorities or organisations of such information as may be necessary to Mayo County Council for that purpose. This may include enquiries from past/present employers and the submission of this application is taken as consent to this.

I, also declare that I have read and understand the Qualifications and Particulars of the post.

SIGNED:______

DATE:______

NOTES

(1)Applicants should give summary of positions held and work carried out in Form B attached.

FORM B

RECORD OF ALL EMPLOYMENT TO DATE

FROM / TO / NUMBER OF MONTHS / EMPLOYER / POSITION HELD