Hand Written Application Forms Will Not Be Considered

APPLICATION FOR EMPLOYMENT HAND WRITTEN APPLICATION FORMS WILL NOT BE CONSIDERED

POSITION APPLIED FOR AND LOCATION

Position: Location

1. Personal Information

Surname: First Names

Home Address Address for Communication (if Different)

Home Telephone No: Work Telephone No:

(will only be used with the utmost discretion) E-Mail Mobile

Do you hold a full clean driving licence? Yes ☐ No ☐

(In order to comply with the Employments Permits Acts 2003 and 2006, please give details which permits you to be employed in the Republic of Ireland)

Do you require a work permit? Yes ☐ No ☐

Successful candidates will be asked to supply proof of identity and other appropriate documentation.

2. Education and Qualifications

Name and Address - Second Level School

Qualification Level Obtained Date Obtained

Name and Address – Third Level (if applicable)

Awarding Body Subject & Grade Achieved Date Awarded

3. Computer Competence – Please Tick As Appropriate

Software Package No Knowledge Limited Extensive Use in Qualification and Familiarity Work Situation Title of Award Microsoft Word

1 3. Computer Competence – Please Tick As Appropriate

Software Package No Knowledge Limited Extensive Use in Qualification and Familiarity Work Situation Title of Award Microsoft Excel

Microsoft Access

Microsoft Power Point Database

4. Additional Training Relevant to this Post

Name of College Course Title F/P Content/ Dates Duration Qualification or Training Details Attended Centre

2 5. EMPLOYMENT RECORD: Please give details of your complete working history beginning with your present or last employment.

Dates employed Employer’s name and Job Title and Full or Part – time, Final Salary Reason for leaving address and nature of description of duties including number of business hours worked From To

3 5. EMPLOYMENT RECORD: Please give details of your complete working history beginning with your present or last employment.

Dates employed Employer’s name and Job Title and Full or Part – time, Final Salary Reason for leaving address and nature of description of duties including number of business hours worked From To

4 6. PLEASE STATE YOUR REASON FOR APPLYING FOR THIS POSITION

7. IF APPOINTED WHEN COULD YOU COMMENCE EMPLOYMENT

8. INTEREST AND VOLUNTARY ACTIVITIES

9. REFERENCES A minimum of 3 references will be required, and the reference from your current/most recent employer should be from your Line Manager. Please note your references must cover the last three years of your employment. One of the references may be known to you in a capacity other than employment. In the event that you need to supply details of further referee’s please us a separate sheet. References will be taken without your permission. 1. 2. Name: Name:

Address: Address:

Telephone Telephone No: No:

Occupation Occupation

How long How long acquainted acquainted with with you? you? In what In what connection? connection?

5 You are invited to include on a separate sheet any relevant supplementary information in support of your application

10. Conditions of Employment All offers of employment are conditional on satisfactory references, Medical Approval and Garda Vetting.

11. Declaration I confirm that information given on this form is, to the best of my knowledge, true and complete. Any false statement may be sufficient cause for rejection or, if employed, dismissal.

If you are appointed it will form the basis of your personal record.

Print Name: Date:

Signature:* Date:

*Shortlisted candidates are required to sign their application form at interview if they have not already done so.

Please complete this application form and return it, together with a cover letter, by e-mail to [email protected]. EPIC is an equal opportunities employer