Application form

for the position of: /
Executive Architect
3 year Fixed Term Contract

This application form, when completed, should be emailed to so as to arrive not later than Tuesday 13th November 2012

1.Name in full (BLOCK LETTERS)______

  1. Postal Address (BLOCK LETTERS)______

______

  1. Telephone No.(s):- ______
  1. Email Address (for contact purposes) ______
  1. GENERAL EDUCATION:-

School or College
Attended / From / To / Examinations / Results
  1. ACADEMIC AND/OR PROFESSIONAL QUALIFICATIONS:-

Full Title Degree(s)
Qual(s) held / Type & Grade of
Honours (1st or 2nd Class, Gr I or II) / Subject(s) in final
Exam / University,
College or
Examining
Authority / Year Degree /
Qual. Obtained
  1. EMPLOYMENT RECORD:-

Give below, in date order, full particulars of all employment (including also any periods of unemployment) between the date of taking up your present position and the date of leaving school or college. No period between these dates should be left unaccounted. If it is necessary to continue on a separate sheet, please set out the information in the same manner as below. Candidates may be shortlisted for interview on the basis of information supplied on their applications.

FROM
/ TO / Name & address of Employer, Details of salary. / Description of duties/responsibilities
  1. COMPETENCIES:-

Having regard to the requirements and duties of the post set out in the Briefing document, please explain in the space provided below why you have the skills and experience necessary to succeed at this position. Please support your answer by examples from your work experience to date.

  1. Give particulars of your knowledge of the Irish Language.

Oral ______Written ______

10.Have you ever been convicted of a criminal offence?______

If so, please give details.______

11.If offered appointment when could you take up duty?______

12.Names and addresses of two responsible persons to whom you are well known but not related and to whom reference may be made as to character. (If you are or have been in employment, one of the referees should be your most recent employer):

(a) / Name: / (b) / Name:
Occupation: / Occupation:
Address: / Address:

13.We require the following information to enable us provide for any needs you may have, should you be called for any stage of this competition, e.g. sign language.

(i)Do you consider that you have a disability?YESNO

(ii)If yes, please give details of your requirements, if any, to enable us to make appropriate arrangements for this competition:

______

______

______

14.Do you hold a current full driving licence?YESNO

Indicate Class(es) of Driving Licence:______

15.Are you registered with the Registration Body as defined by the Building Control Act 2007? YES  NO 

16.Before signing this form please ensure that you have replied fully to all questions. You should also satisfy yourself that you are eligible under the Qualifications. The City Council cannot undertake to investigate the eligibility of candidates in advance of the interview/examination, 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.

Usual Signature:______Date:______

LIMERICK CITY COUNCIL IS AN EQUAL OPPORTUNITIES EMPLOYER

INTERVIEW SIGN IN:______