Post Applied For
Post Reference
Location / Commuting Distance
(Home to Work)* Dyfed Powys

SECTION 1 – ABOUT YOU

THIS SECTION WILL BE REMOVED PRIOR TO SHORTLISTING

Surname:
Forename(s):
Known As Name: (If you are known by a name other than your first forename)
Date of Birth:
Home Address:
Postcode:
Home Telephone Number:
Mobile Telephone Number:
Email Address:
Preferred Method of contact: (Telephone/Email/Letter)
Force Number
Current Force (Delete as applicable)
Current Role Title
Current Department/Location
Gender Identity
What is your gender?
Male Female
Do you identify as transgender?
Yes No Prefer Not to Say
Do you identify as transsexual?
YesNoPrefer Not to Say
Sexual Orientation
Which of the following options best describes how you think of yourself?
Heterosexual Bisexual Prefer Not to Say
Gay or Lesbian Other
Religion or Belief
Which of the following options best describes your religion or belief?
BuddhistJewishNone
ChristianMuslimPrefer Not to Say
HinduSikhOther Please specify
Disability
Do you consider yourself to have a disability?
Yes No Prefer not to say
If you have answered Yes, please categorise your disability:
Hearing Mobility
Learning Difficulty Visual
Mental Health Condition Other Please specify
‘Disability’ means any physical or mental impairment, which has a substantial and long-term (over 12 months) adverse effect on your ability to carry out normal day to day activities.
Ethnicity
Which of the following options best describes your ethnicity?
Asian or Asian British / A1Indian
A2Pakistani
A3Bangladeshi
A9Any other Asian background
Black or Black British / B1Caribbean
B2African
B9Any other Black background
Mixed / M1White and Black Caribbean
M2White and Black African
M3White and Asian
M9Any other mixed background
Chinese or any other ethnic group / O1Chinese
O9Any other ethnic background
White / W1British
W2Irish
W9Any other white background
Prefer not to say / NSPrefer not to say
Welsh Language Ability
Please consider your ability to use the Welsh language in an office, performing operational duties, on a Police Station Counter or reception desk, on the telephone, at meetings and when dealing with the media. Which of the following options best describes your ability?
Level 0 / No Welsh ability
Level 1 / Greet, introduce and open and close conversations. Say place names, first names and signs correctly. Recognise departments, locations and ranks. Give and receive personal details. Open and close meetings and write simple requests.
Level 2 / Understand essence of conversation and respond to simple requests.
Convey basic information and transfer telephone calls. Partly contribute in meetings. Write simple notes of request.
Level 3 / Understand much in an office or meeting. Take details and pass on messages. Converse partly in Welsh and respond to general enquiries over the phone and face to face. Present partly in Welsh at meetings. Write informal memos and e-mails and deal with routine requests.
Level 4 / Contribute effectively and provide presentations in meetings. Deal with complex enquiries and complaints. Interview or question in the course of an investigation. Deal confidently with hostile questions and confrontations. Write reports and make full and accurate notes.
Level 5 / Contribute effectively and provide presentations in meetings. Deal with complex enquiries and complaints. Interview or question in the course of an investigation. Deal confidently with hostile questions and confrontations. Write reports and make full and accurate notes. Interview applicants for posts and assess suitability.

Successful applicants will be required to undergo vetting and by willing to provide medical disclosure to their Home Force Occupational Health Unit.

I declare that the information provided on this form is true.

Signed:
Date:

- BLANK PAGE -

SECTION 2 - YOUR QUALIFICATIONS AND TRAINING

Starting with the most recent, please give details of academic and professional qualifications and training which are relevant to the role.

Examination /
Training Type / Subject / Date Passed/Due to be Taken / Grade Achieved/Projected

SECTION 3 - COMPETENCY ASSESSMENT

Relevant Experience, Skills, Knowledge and Personal Qualities

Please provide evidence of how you meet the relevant experience, skills, knowledge and personal qualities criteria outlined in the Role Profile (Maximum 250 words per section). Please refer to the Matrix Table at the end of the role profile for information on which relevant experience, skills, knowledge and personal qualities are to be evidenced and assessed against at shortlisting Stage.

Skills
Knowledge
Serving the Public
Professionalism
Openness to Change
Service Delivery
Decision Making
Working with Others

SECTION 4 – LINE MANAGER COMMENTS

Applicant must forward Section 4 – Line Manager Comments to line Manager, once you have completed your name, post applied for and closing date of the vacancy.

Send in your application separately from your Line Manager’s comments. There is no requirement for your line manager to view your completed application. It is the responsibility of the Line Manager to ensure their comments are forwarded to Employee Resources in line with the published closing date.

Applicant Details (to be completed by applicant)

Surname:
Forename(s)
Force Number
Post Applied For: / Closing Date:

Line Managers Comments

Are you aware of any reason why this application should not be supported;

YesNo

If yes, please complete the following;

  • The individual is currently on an Action Plan YesNo (Performance/Attendance).
  • The individual currently occupies a role in whichYesNo

There hasn’t been a sufficient return on investment

In relation to training provided.

  • Other (please specify)

Signed______Date______

Name______Force Number______

This section of the form MUST be completed by your Line Manager to support your application. If it is not supported, your application will not be considered.