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					ADVICE PAGE – DO NOT RETURN WITH APPLICATION
Instructions for using word to complete your application form - Click in the grey areas on the form to type. - Please use Arial size 10 at all times. - All sections must be filled in - Please only use the space provided. - Do not include CV’s - Incomplete application will not be considered. - Do not alter page layout. - If you have any special needs or requirements in completing the application please contact the personnel section

COOKSTOWN
DISTRICT COUNCIL
AN EQUAL OPPORTUNITIES EMPLOYER

JOB REF NO APPLICANT REF NO

APPLICATION FORM
IN CONFIDENCE/ PLEASE COMPLETE IN BLACK INK OR TYPESCRIPT ONLY APPLICATIONS CONTAINING ALL THE INFORMATION WHICH HAS BEEN SOUGHT WILL BE CONSIDERED. CANVASSING WILL DISQUALIFY. POST OF:
PLEASE RETURN COMPLETED FORMS IN AN ENVELOPE MARKED TO: COOKSTOWN DISTRICT COUNCIL, COUNCIL OFFICES, BURN ROAD, COOKSTOWN BT80 8DT BY: 4.00 PM ON FRIDAY 16 OCTOBER 2009 (Late applications will not be considered) (Please do not include CV with application form)
(Please click the grey areas to type)

ENFORCEMENT/NEIGHBOURHOOD OFFICER

SURNAME HOME ADDRESS
Address 1 Address 2 Town County

TITLE (MR MRS, MISS, MS)

FIRST OR GIVEN NAMES DATE OF BIRTH (DD/MM/YYYY) HOME TEL NO

POSTCODE

ADDRESS FOR CORRESPONDENCE (IF DIFFERENT)
Address 1 Address 2 Town County POSTCODE

DAYTIME TEL NO

NATIONAL INSURANCE NO

DO YOU HOLD A CURRENT FULL DRIVING LICENCE? YES DO YOU HAVE ACCESS TO A MOTOR VEHICLE? YES

NO NO

TYPE:PRIVATE/HGV etc.
Tick which is appropriate

Under the Rehabilitation of Offenders (Exceptions) Order Northern Ireland, 1979, COOKSTOWN DISTRICT COUNCIL is included in the list of excepted employments. As such, any criminal conviction may never be regarded as spent and must be disclosed when applying for a post within the Local Government Service. IT IS NECESSARY THEREFORE TO ASK THE QUESTION: HAVE YOU EVER BEEN CONVICTED OF ANY CRIMINAL OFFENCE? IF YES PLEASE GIVE DETAILS YES NO

It should be noted however, that disclosure of a conviction does not necessarily debar any applicant from obtaining employment.

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EDUCATION
EDUCATION FROM THE AGE OF TWELVE SUBJECTS STUDIED LEVEL ATTAINED & EXAMINING BODY GRADE YEAR

FURTHER EDUCATION
DEGREE/DIPLOMA/CERTIFICATE YEAR OBTAINED EXAMS TO BE TAKEN

PROFESSIONAL QUALIFICATIONS
NAME OF PROFESSIONAL BODY PART NO. WITH DATE AND RESULT FINAL WITH DATE AND RESULT EXAMINATIONS YET TO BE TAKEN

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EMPLOYMENT HISTORY
PRESENT POST (JOB TITLE) NAME & ADDRESS OF PRESENT EMPLOYER DEPARTMENT OF POST (INCLUDE LOCATION)

DATE APPOINTED REASON FOR LEAVING

GRADE OF POST

PRESENT SALARY/WAGE

PERIOD OF NOTICE

PRINCIPAL DUTIES OF PRESENT POST

EXPERIENCE Please list your previous posts beginning with the most recent.
NAME & ADDRESS OF EMPLOYER POSITION DUTIES (BRIEFLY) EXACT DATE OF EMPLOYMENT FROM TO DD/MM/YY DD/MM/YY

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PLEASE STATE HOW YOU MEET THE CRITERIA AND DEMONSTRATE SPECIFIC EXPERIENCE AND CORE COMPETENCIES BY WAY OF PERSONAL AND SPECIFIC EXAMPLE (Continue on a separate sheet if needed) QUALIFICATIONS & EXPERIENCE Essential Criteria Applicants must possess
EITHER a minimum of 5 GCSE’s (Grades A-C), or equivalent and at least 5 years’ recent work experience, involving crime reduction , community safety, (or similar regulatory or enforcement type activity). This work experience should include: Inter- Agency working and Working with members of the public / local communities. OR a third level qualification in Law, Criminology, Environmental Health, or similarly related discipline and at least 2 year s’ work experience, within the past 5 years, involving crime reduction , community safety, (or similar regulatory or enforcement type activity). This work experience should include: Inter- Agency working and Working with members of the public / local communities.

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PLEASE STATE HOW YOU MEET THE CRITERIA AND DEMONSTRATE SPECIFIC EXPERIENCE AND CORE COMPETENCIES BY WAY OF PERSONAL AND SPECIFIC EXAMPLE Core Competencies Proficient verbal and written communications skills in English yes no -Please give details of having a good standard of literacy and comprehension in i.e. the ability to draft letters and reports, and excellent oral communication skills i.e. the ability to deal with internal departments and external bodies and the community/ voluntary sector on a range of community safety issues.

-Please give details of your ability to set clear work targets and monitor performance.

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PLEASE STATE HOW YOU MEET THE CRITERIA AND DEMONSTRATE SPECIFIC EXPERIENCE AND CORE COMPETENCIES BY WAY OF PERSONAL AND SPECIFIC EXAMPLE Core Competencies - Please give details of your ability to engage and develop partnership style working.

-Please give details of your ability to gather and analyse information and make day to day decisions on operational issues which affect others

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PLEASE STATE HOW YOU MEET THE CRITERIA AND DEMONSTRATE SPECIFIC EXPERIENCE AND CORE COMPETENCIES BY WAY OF PERSONAL AND SPECIFIC EXAMPLE Key Competencies - Please state your ability to deal with the public and others in a sensitive way that diffuses any negativity, even in potentially contentious and unpredictable situations .

- Please give details of your ability to make effective use of Information Technology and associated equipment .

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PLEASE STATE HOW YOU MEET THE CRITERIA AND DEMONSTRATE SPECIFIC EXPERIENCE AND CORE COMPETENCIES BY WAY OF PERSONAL AND SPECIFIC EXAMPLE Key Competencies - Please give details of your understanding of the importance of health and safety in high risk situations and of the necessary precautionary measures

- Please give details of your ability to be proactive, innovative and work enthusiastically with others to exceed standards

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PLEASE STATE HOW YOUR EXPERIENCE TO DATE HAS A BEARING ON YOUR PRESENT APPLICATION. ( PLEASE PROVIDE ANY ADDITIONAL INFORMATION YOU CONSIDER RELEVANT)

PLEASE DESCRIBE ANY OTHER ACTIVITIES WHICH MAY BE OF INTEREST IN RELATION TO THIS APPLICATION (E.G. PUBLICATIONS, COURSES ATTENDED, INTERESTS, ETC).

PLEASE NAME TWO REFEREES, AT LEAST ONE OF WHOM SHOULD HAVE KNOWLEDGE OF YOUR PRESENT WORK AND BE IN A SUPERVISORY/MANAGERIAL CAPACITY. (RELATIVES SHOULD NOT BE NAMED
AS REFEREES)

NAME DESIGNATION/ OCCUPATION ADDRESS

NAME DESIGNATION/ OCCUPATION ADDRESS

POSTCODE

POSTCODE

Tel No

Tel No

YOUR PRESENT EMPLOYER WILL ONLY BE CONTACTED SHOULD YOU BE CONSIDERED FOR APPOINTMENT

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MEDICAL HISTORY Have you been absent from work due to sickness in the past two years? yes If yes please give brief details and approximate dates of any periods of sickness
REASON FOR SICKNESS

no

LENGTH OF ABSENCE FROM WORK

DOCTOR'S NAME

DOCTOR'S ADDRESS

Do you have a medical condition which may affect your performance of the job? If yes please give details:

yes

no

DECLARATION AND SIGNATURE I understand and accept that the particulars given are complete and correct to the best of my knowledge. Any candidate found to have given false information or to have wilfully suppressed any material will be liable to disqualification and if appointed, dismissal.

USUAL SIGNATURE __________________________________ DATE: ________________

PLEASE ENSURE THAT THE MONITORING QUESTIONNAIRE IS COMPLETED

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EQUAL OPPORTUNITIES MONITORING QUESTIONNAIRE EXPLANATORY NOTES
Cookstown District Council is committed to promoting equality and diversity. It is our policy to provide employment equality to all, irrespective of gender, including gender reassignment, marital status or civil partnership status, having or not having dependants, religious belief, political opinion, disability, age, race, nationality, sexual orientation, trade union membership or non membership or criminal record. We are opposed to all forms of unlawful and unfair discrimination. All job applicants, employees and others who work for us will be treated fairly and will not be discriminated against on any of the above grounds. Decisions about recruitment and selection, promotion, training or any other benefit will be made objectively. As an equal opportunities employer, we want to ensure that all of our applicants and employees enjoy equality of opportunity. We also want to encourage the best people to apply for vacancies in our council regardless of their background. The information provided on the monitoring questionnaire will only be made available to the Council’s monitoring officer and will remain confidential except in the event of a tribunal complaint. If we make equal opportunities information public, this will be done in a way that ensures that individuals are not identified. To ensure confidentiality, the questionnaire will be given an identifying number and only the Council's Monitoring Officer will be able to match this number with your name. Your name should not be written on the questionnaire. This questionnaire has been agreed with, and has the support of, the recognised trade unions and the Equality Commission for Northern Ireland. The monitoring information collected will be used to:  provide us with information on the profile of individuals applying to the Council for jobs  measure the effectiveness of our equal opportunity policy  determine the extent to which we promote equality of opportunity and fair participation  assist us to develop and review positive/affirmative action policies. If you have any queries about this questionnaire, please contact our Monitoring Officer on 028 8676 2205 or Text Phone 028 8676 5827

EQUAL OPPORTUNITIES STATEMENT The Council is committed to an active equal opportunities policy from recruitment and selection, through training and development, appraisal and promotion to retirement. It is the intention of the Council to actively strive to promote an environment free from discrimination, harassment and victimisation, where everyone will receive fair and equal treatment regardless of gender, colour, race or national origin, disability, age, marital status, sexual orientation or religion. All decisions relating to employment practices will be objective, free from bias and based solely upon work criteria and individual merit. The Council is responsive to the needs of its employees and the community at large in its duty to deliver best value by providing a consistently efficient and effective service. It is the Council's policy to sustain a culture which engages everyone's talents and abilities and where diversity is valued.

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Equal opportunity monitoring form

STRICTLY CONFIDENTIAL
Religious affiliation and/or community background Regardless of whether we practise religion, most of us in Northern Ireland are seen as either Roman Catholic or Protestant. Please indicate your community background by ticking the appropriate box below: Protestant community Roman Catholic community Neither Protestant nor Roman Catholic community

If you do not complete the above question, we are encouraged to use the “residuary” method which means that we can make a determination on the basis of personal information on file/application form.

Please indicate your gender by ticking the appropriate box below: Gender: Male Female

My Date of birth:

Are you married/in a civil partnership?

Yes

No

Do you look after, or have responsibility for: Your Children Other Relative(s) Other None

Under the Disability Discrimination (NI) Act 1995 a disabled person is considered to have a disability if he/she has a physical or mental impairment which has a substantial and long term adverse effect on his/her ability to carry out normal day to day activities. Please note that it is the effect of the impairment, without treatment, which determines if an individual meets this definition of disability. Do you consider that you meet this definition of disability? Yes If yes, please state the type of disability: Physical Disability Mental Health Disability Learning Disability No

How would you describe your ethnic group? White Black-other Indian Pakistani Bangladeshi Chinese Other Black African (please specify) Black-Caribbean

Irish Traveller

Mixed Ethnic Group

Please state your nationality or citizenship (for example, British, Irish, Portuguese, Polish):

Do you have a religious belief? If yes is it: Christian

Yes Muslim

No Buddhist Hindu Other

My sexual orientation is: Hetrosexual (straight) Homosexual (gay/lesbian) Bisexual Other I do not wish to answer this question

Additional information To monitor the effectiveness of our advertising please indicate where you saw this position advertised: Belfast Telegraph Mid Ulster Mail Recruit NI Tyrone Courier Council Website Mid Ulster Observer Department of Learning, Jobs and Benefits Other state where:

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