Application Form - PDF format - Northern Ireland Fire & Rescue ...

IMPORTANTAll sections of this application form must be completed. It is the applicant’s responsibility to providesufficient information for the application to be assessed and care should be taken to ensure that thedetails are full, accurate and relevant to the requirements set out for the post. If this form is scannedthe format and content must remain unaltered. Additional sheets should not be inserted norcurriculum vitae attached.1. Full Name2. Address3. Telephone No HomeMobileWork4. Service No (if applicable)5. Are you an EC NationalIf no - do you require awork permit to work inNorthern IrelandYesYes6. Academic And Professional QualificationsDegrees, Diplomas or Certificates AwardedPlease list degrees, diplomas or certificates obtained giving full details of classification/type of passand year.NoNoProfessional Qualifications (by examination)Professional BodyPlease list examinations and year passed, subjects taken and dates.Membership of any other Professional Bodies (State grade of Membership)Assistant Chief Fire Officer Date of Issue: Feb 2011 Page 2 of 16Ref: U002/02/2011-U003/02/2011

10. Outline Experience and TrainingAssistant Chief Fire Officer Date of Issue: Feb 2011 Page 4 of 16Ref: U002/02/2011-U003/02/2011

1 EXPERIENCE AND QUALIFICATIONSEssential1.1 Candidates must have successfully completed the Brigade Command Course at the Fire ServiceCollege or the Executive Leadership Programme, or have acquired qualifications equivalent tothese courses.Assistant Chief Fire Officer Date of Issue: Feb 2011 Page 6 of 16Ref: U002/02/2011-U003/02/2011

1.2 Be able to demonstrate a wide range of operational and technical experience at AreaCommander level or above within the last 3 years. This must include experience in thestrategic command of critical incidents including those of potential regional, national andinternational significance.Assistant Chief Fire Officer Date of Issue: Feb 2011 Page 7 of 16Ref: U002/02/2011-U003/02/2011

1.3 Be able to demonstrate a comprehensive range of managerial experience within a fire serviceincluding, eg, leadership, resources/financial management, decision-making, research &development and leading special projects.Assistant Chief Fire Officer Date of Issue: Feb 2011 Page 8 of 16Ref: U002/02/2011-U003/02/2011

Desirable1.4 Member of the Institution of Fire Engineers.1.5 A Degree in an appropriate allied discipline such as fire engineering, public policy and planning,business, finance or management.1.6 Evidence of substantial continuous professional development through, eg, availing of leadershipdevelopment opportunities and contributing to fire service development at national level.Assistant Chief Fire Officer Date of Issue: Feb 2011 Page 9 of 16Ref: U002/02/2011-U003/02/2011

Any further notes in support of your application (Detail here any additional information not alreadyincluded elsewhere)Assistant Chief Fire Officer Date of Issue: Feb 2011 Page 10 of 16Ref: U002/02/2011-U003/02/2011

Assistant Chief Fire Officer Date of Issue: Feb 2011 Page 11 of 16Ref: U002/02/2011-U003/02/2011

DisabilityNorthern Ireland Fire & Rescue Service welcomes applications from disabled persons who meet theselection criteria. If you have a disability please indicate any relevant effects of your disability andsuggest adjustments which might help you to overcome any disadvantages you might expect toencounter in the recruitment process.Criminal ConvictionsHave you at any time been convicted of a criminal offence which, as yet, is not "spent" under the termsof the Rehabilitation of Offenders (NI) Order 1978?YesNoIf answer is yes please give details:Assistant Chief Fire Officer Date of Issue: Feb 2011 Page 12 of 16Ref: U002/02/2011-U003/02/2011

ReferencesPlease give the names and addresses of two persons of professional standing from whomreferences may be sought as to your suitability for the post. One of these must be your presentemployer.Name:Address:Name:Address:Occupation:Email:Telephone Number:Occupation:Email:Telephone Number:CANVASSINGCanvassing of Northern Ireland Fire & Rescue Service Officers or Members of the NIFRS Board inany form, oral or written, directly or indirectly, in connection with this appointment shall disqualifya candidate.DECLARATIONI declare that the information contained in this application form is correct to the best of myknowledge.I also accept that if I have provided false or misleading information this will render my applicationinvalid and any appointment offered will be rescinded or terminated.Signed:Date:Assistant Chief Fire Officer Date of Issue: Feb 2011 Page 13 of 16Ref: U002/02/2011-U003/02/2011

NORTHERN IRELAND FIRE & RESCUE SERVICEEQUALITY MONITORING QUESTIONNAIREThis form will be detached from your application before the selection procedure commences. The information which you supplywill be used only for the purpose of Equality Monitoring and will be held in confidence.PART A - FAIR EMPLOYMENTUnder the Fair Employment (Northern Ireland) Act 1989 you are requested to supply the following information:Please indicate the community to which you belong by ticking the appropriate box:I am a member of the Protestant communityI am a member of the Roman Catholic communityI am a member of neither the Protestant or Roman Catholic communityPART B - MARITAL STATUS AND GENDERPlease tick the appropriate box:MARRIED SINGLE OTHER (PLEASE SPECIFY)Please also tick where appropriate:MALEFEMALEPART C - DISABILITYDEFINITION OF DISABILITYSection 1 of the Disability Discrimination Act defines a person as having a disability if he or she ‘has a physical or mentalimpairment which has a substantial and long-term adverse effect on his or her ability to carry out normal day to day activities’.DO YOU HAVE SUCH A DISABILITY? YESNOPLEASE DESCRIBE THE NATURE OF YOUR DISABILITYPART D - ETHNIC ORIGINPlease tick one of the following boxes:WHITE EUROPEAN AFRO-CARIBBEAN ASIAN CHINESEINDIAN SUB-CONTINENT)OTHER (PLEASE SPECIFY)PART E - AGEDATE OF BIRTHAGENB: YOUR NAME MUST NOT APPEAR ANYWHERE ON THIS QUESTIONNAIRE.______________________________________________________________________FOR OFFICE USE ONLYPOST: Assistant Chief Fire OfficersJOB REF NO: U002/02/2011-U003/02/2011CANDIDATE NO:Assistant Chief Fire Officer Date of Issue: Feb 2011 Page 14 of 16Ref: U002/02/2011-U003/02/2011

NORTHERN IRELAND FIRE & RESCUE SERVICEHUMAN RESOURCES DEPARTMENT USE ONLYThis information is required only in connection with interview arrangements and will not be attached withyour application at time of interview.NameApplication ForAssistant Chief Fire OfficersI am not related to any Member(s) of the NIFRS Board or Officer(s) of Northern Ireland Fire & RescueService.I am related to the undernoted Member(s) of the NIFRS Board or Officer(s) of Northern Ireland Fire &Rescue Service:(Delete as appropriate)Member(s)/Officer(s)RelationshipMember(s)/Officer(s)RelationshipMember(s)/Officer(s)RelationshipRef NoCandidate NoU002/02/2011-U003/02/2011Assistant Chief Fire Officer Date of Issue: Feb 2011 Page 15 of 16Ref: U002/02/2011-U003/02/2011

NORTHERN IRELAND FIRE & RESCUE SERVICEASSISTANT CHIEF FIRE OFFICERSIn the box alongside each vacancy you should indicate the post(s) you are applying for by giving yourorder of preference for the posts. Your first choice should be number 1 and so on until you have indicatedall the posts you are applying for. If you are not applying for a particular post, leave the box alongsideblank.Number the boxes 1 – 2 in order of preference.Assistant Chief Fire Officer (Technical Development)Assistant Chief Fire Officer (Community Development)PreferenceJob Ref NoU002/02/2011U003/02/2011SIGNATURE:DATE:This form must be returned with your application.Assistant Chief Fire Officer Date of Issue: Feb 2011 Page 16 of 16Ref: U002/02/2011-U003/02/2011