APPLICATION FORM

YMCA STEP Tutor Dublin City (Fixed Term Contract)

SURNAME (in capitals) / First Names (in capitals)
(underline the name you are usually known by)
Do you require a Work Permit to enter employment within the European Union? / Yes No
PERMANENT ADDRESS
Telephone Number
Mobile Number
Email address
PRESENT ADDRESS (if different from above)
TELEPHONE NO:
NAME AND ADDRESS OF NEXT OF KIN
POSITION APPLIED FOR

EDUCATION

SECONDARY

School Attended
(Name and Address) / Entered / Left / Leaving Certificate (or equivalent)
Subjects Taken
Subject
(Higher) / Result / Subject
(Lower) / Result

THIRD LEVEL

Qualifications Title of Award (Cert/Diploma/Degree/Professional Qualification or Higher) / f/t or p/t / Duration / Grade Achieved (eg First Class Honours etc) / University/
College Attended / Awarding Body eg NUI, HETAC etc / Year of Award

COMPUTER COMPETENCE

Please tick as appropriate to indicate proficiency in the following:

Software Package / No Knowledge / Limited Knowledge / Extensive Use in Work Situation / Qualification
(if held)
Microsoft Word
Microsoft Excel
Microsoft Access
Microsoft PowerPoint
Google Docs
Google Sheets
Other ( please specify)

ADDITIONAL TRAINING RELEVANT TO THIS POST

Title of Course Attended / Name of College/Training Centre attended / Full/
Part-time: / Content/
Details
of Course / Dates attended / Duration / Qualification attained (if relevant):

EMPLOYMENT

Start with your current employer and work backwards through your career. Please include any previous positions with your present employer.

Period in Months / Full/Part-time / Inclusive Dates
From / To / Employer’s Name, Business and Location / Brief Job Description and Main Responsibilities / Reason for Leaving

Reasons for Applying for this Post

In 250 words or less, please give the reasons why you are applying for this post?

INTERESTS

What are your leisure-time interests? If you have held any posts of responsibility in connection with these, please give details.

OTHER QUALIFICATIONS AND EXPERIENCE

If you have any qualifications and/or experience relevant to the job for which you are now applying, which are not given elsewhere on the form, please list here

PERSONAL CIRCUMSTANCES

Do you hold a current Full Driving LicenseYesNo

Do you have access to a car? YesNo

DECLARATION
The nature of the job for which you are applying will bring you into direct contact with children and young people, either as service users in their own right or the children of service users.
As part of the YMCA’s Child Protection Policy the successful candidate will be asked to complete Garda Vetting.
We therefore ask you to sign the following declaration.
Declaration of a conviction will not necessarily mean disqualification from appointment. However, if it is subsequently found that you failed to declare a conviction, this will be regarded as gross misconduct which could lead to your employment being terminated.
The information you provide will remain confidential.
Please give details, including date, offence and sentence of all criminal convictions below:
If none, please write none and sign and date.
Date / Nature of Offence / Sentence
If required, I will complete Garda Vetting.
I confirm that the information supplied in this Application Form is true and accurate.
Signed Date

REFERENCES

Please give the name and address of three persons (not relatives), one of whom should be your present or recent employer and whom you have asked to act as your referees.

No approach will be made to your current employer without your consent.

1.Name
Occupation / Address
Telephone Number
2.Name
Occupation / Address
Telephone Number
3.Name
Occupation / Address
Telephone Number

This form, when completed, should be emailed to:

CLOSING DATE FOR RECEIPT OF APPLICATIONS Wednesday, the 7th of March, 2018

Short-listing will apply based on the criteria in advertisement. YMCA reserves the right to apply additional shortlisting criteria.

Interviews are provisionally scheduled to be held in Dublin YMCA.

It is not YMCA Ireland policy to pay for travelling expenses to interviews.

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