NRS0848 Nursing & Midwifery Graduate Initiative

NRS0848

Phase 2: Graduate Nurse - (General) or (Mental Health) or (Intellectual Disability) or Graduate Midwife

Job Titles: Graduate Nurse (General) Grade Code: 2852, Graduate Nurse (Mental Health) Grade Code:2854, Graduate Nurse (Intellectual Disability) Grade Code: 2853, Graduate Midwife Grade Code: 2850

 Applicants please ensure that you read Nursing & Midwifery Graduate Additional Information before beginning this application form.  Read the application form carefully, filling out all sections with the information requested.  Review your application form to ensure you have completed all sections. All fields must be completed. Incomplete fields / sections may result in your Application Form not being processed further.  Verify that you have attached a scanned copy of your Nursing & Midwifery Board of Ireland (NMBI) / Bord Altranais agus Cnáimhseachais na hÉireann Annual Retention Certificate (relevant Division of the Register). Applications received without a valid NMBI Annual Retention Certificate will be deemed ineligible.  Verify that you have attached a scanned copy of the photograph page of your passport. Applications received without a scanned copy of the photograph page of your passport will be deemed ineligible.

An Application for: NRS0848 Nursing & Midwifery Graduate Initiative must contain: 1. Fully completed Application Form 2. Scanned copy of NMBI Annual Retention Certificate (relevant Division) 3. Scanned copy of the photograph page of your passport

Closing date & time: Friday 1st March 2013 at 12.00 noon

Address: by email [email protected] or by post to: National Recruitment Service, HSE, Aras Slainte Chluainin, Manorhamilton, Co. Leitrim

Personal Details

First Name:

Last Name/Surname:

Email Address: (Mandatory)

Mobile Telephone Number: You must include int’l access code (Mandatory) Postal Address

I am a European Economic Area (EEA) National* or a Swiss National*? Please tick Yes or No

YES NO

*A citizen/national of a European country who does not require a work permit to work in Ireland. Applicants who answer No to this question must provide the documents listed on Page 9 of Graduate Nurse Additional Campaign Information. Page 9 provides more information on EEA Nationals. Candidates who answer No to this question and who do not provide the relevant documentation will be deemed ineligible.

Nursing & Midwifery Graduate Initiative 1 Application Form NRS0848

Eligibility Criteria

I possess a primary nursing/midwifery qualification awarded in a member state of the European Union in the year? Please tick the year: 2012 2010

2011 I graduated in another year (Please note if you graduated in a year other than 2012, 2011 or 2010 you are not eligible to apply for this graduate initiative)

I am registered on the Division of the register maintained by the Nursing & Midwifery Board of Ireland that I have marked below:

General Division Mental Health Division

Intellectual Disability Division Midwifery Division My NMBI PIN number is: Please enter PIN in the box  You must provide your NMBI PIN or your application will be deemed ineligible.  Please ensure you include a scanned copy of your Nursing & Midwifery Board of Ireland Annual Retention Certificate when submitting your application form.  Applications received without a valid NMBI Annual Retention Certificate will be deemed ineligible

A: Please tick the College/University in the Republic of Ireland from which you graduated in 2012, 2011 or 2010 with a Bachelor of Science degree in General/Intellectual Disability/Mental Health Nursing or Midwifery. B: If you attended a College/University outside of the Republic of Ireland but within the European Economic Area, please tick the country in which you were awarded a primary nursing qualification. A B I graduated in 2012, 2011 or 2010 in the Republic of I graduated in 2012, 2011 or 2010 in a country other than the Ireland from a college listed below: Republic of Ireland:

Colleges/Universities in the Republic of Ireland Country of Qualification Mark your college with an X Mark the country with an x Dublin City University Austria Liechtenstein IT Athlone Belgium Lithuania IT Dundalk Bulgaria Luxembourg IT Galway/Mayo Cyprus Malta IT Letterkenny Czech Republic Norway IT Tralee Denmark Poland IT Waterford Estonia Portugal National University of Ireland Galway Finland Romania St Angela's College Sligo (NUIG) France Slovakia Trinity College Dublin Germany Slovenia University College Cork Greece Spain University College Dublin Hungary Sweden University of Limerick Iceland Switzerland Italy The Netherlands Latvia United Kingdom I graduated from a country other than those listed above: Please provide country name in the space below:

Direct Entry Student: You started your nursing qualification directly after finishing secondary/high school Mature Entry Student: You started your nursing qualification as a mature student*

Please indicate if you were a direct Direct Entry Mature Entry entry student or a mature entry Graduate Graduate student Please tick appropriate box *23 years of age or over at the time of application for your nursing qualification Nursing & Midwifery Graduate Initiative 2 Application Form NRS0848

Geographic Preference

1. Please ensure that you read page 5 and Appendix 3 page 10 Nursing & Midwifery Graduate Additional Campaign Information before choosing a geographic preference. 2. The panels formed for the geographic areas below are those that the NRS will access to fill vacancies at a particular hospital or community service within that geographic area. 3. We cannot predict if, when or where Graduate posts will occur at this stage of the process. Therefore you should make your choice based on where (geographically) you would most like to work. 4. Changes to geographic choice will not be accepted after the closing date and time for receipt of applications i.e. Friday 1st March 2013 at 12 noon.

You may choose a single geographical area from the 16 choices listed below.

Geographic Area Please mark your single choice with an X

1 Carlow / Kilkenny / South Tipperary

2 Cavan / Monaghan

3 Cork

4 Donegal

5 Dublin North & Dublin North City

6 Dublin South Central

7 Dublin South East / Wicklow

8 Dublin South West / Kildare / West Wicklow

9 Galway / Roscommon

10 Kerry

11 Louth / Meath

12 Mayo

13 Mid West

14 Midlands

15 Sligo / Leitrim / West Cavan

16 Waterford / Wexford

Please note changes to geographic preferences will not be accepted after the closing date and time of: Friday 1st March 2013 at 12 noon

Data Protection Release, Final Clinical Placement & Security Clearances Section D – Medical School confirmation of dates of completion and conferral of

Applicant & College Details:

First Name:

Last Name:

Name of College:

Name of Allocations Officer (College) I, a graduate in General, Intellectual Disability, Mental Health Nursing or Midwifery from the above named college, permit the HSE National Recruitment Service to seek and receive my centile ranking from the above college for the purposes of creating an order of merit for the Nursing & Midwifery Graduate Initiative.

Final Clinical Placement Details:

I completed my final pre graduation Internship in the following hospital(s)/site(s):

If you answered no, please The duration of my final pre Yes No provide length of final pre graduation Internship was 36 graduation Internship in weeks weeks The name(s) of my final intern Clinical Placement Co-Ordinator(s) (CPC) was / is :

All Graduates The HSE National Recruitment Service will seek references from: the Clinical Placement Co-Ordinator , the Director of Nursing (or their nominee) at your final pre graduation Internship placement and from your College / University. By completing your application for this Graduate programme you are pre authorising our office to seek references. Graduates 2010 & 2011 only In addition to the above, the HSE National Recruitment Service will seek an additional two references, for which you must provide details on the next page of this application form.

Security Clearance Details:

Date of Birth

Last Name: I authorise the HSE Garda Vetting Liaison Office to access Security Clearance (national and international) previously obtained for my pre graduation Student Nurse Placements.

Residency I have not I have left I live in the Republic of Ireland or Northern Ireland. I left for for more have not left for a period of 6 months or longer since I more than than 6 attained 16 years of age. 6 mths mths

If you state that you have left for more than 6 months and resided elsewhere, it will be mandatory for you to provide us with a Police Clearance Certificate(s) from that county(ries) stating that you have no convictions recorded against you at a later stage in the process. More details available in Appendix 4 page 11.

2011 Graduates & 2010 Graduates

 ALL - 2011 Graduates  ALL - 2010 Graduates

Are required to fill out this section of the application form. 2012 Graduates are not required to fill out this section of the application form.

Q 1 - Graduates 2010 & 2011 only – please provide 2 additional Previous Employer Referees

Name: Email Address: REF Job Title Employer: 1 Mobile Tel No. Landline Tel No.

Name: Email Address: REF Job Title Employer: 2 Mobile Tel No. Landline Tel No.

Q 2 - Please enter the year in which you left full- time secondary / high school

Q 3 - Please detail below all career / educational history from the time you left-full time secondary / high school (e.g. if you spent time following a different career path, spent time out of work, returned to full time education, worked as a nurse (full time or part time). Please ensure there are no gaps from when you left secondary / high school to the present date. A sample is available in Appendix 7 page 14 in the guide Graduate Nurse/Midwife Additional Campaign Information.

From Date To Date Average Name of Employer / Name of Title of Post / Name DD/MM/YY DD/MM/YY Monthly Hours Educational Institution of Course

Application Check – All Applicants

You are required to submit by Friday, 1st March 2013 @ 12 noon:

1. A completed Application Form, please review your form to ensure you have completed all sections 2. Ensure you have not made more than a single geographic choice 3. Scanned copy of active NMBI Annual Retention Certificate (relevant Division) 4. Scanned copy of the photograph page of your passport

Equality Monitoring Section

Candidates please note, this data is for administrative records only, and does not form part of the selection process, or any portion of the appointments process.

Candidate Name: Date of Birth:

Nationality:

Male: Female:

Nursing & Midwifery Graduate Initiative 6 Application Form