IMPORTANT NORTHERN IRELAND FIRE & RESCUE SERVICE PROCESSES THE INFORMATION PROVIDED ON THIS FORM FOR THE PURPOSES OF MEETING ITS LEGAL OBLIGATIONS.

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1 IMPORTANT ALL SECTIONS OF THIS APPLICATION FORM SHOULD BE COMPLETED. IT IS THE APPLICANT'S RESPONSIBILITY TO PROVIDE SUFFICIENT INFORMATION FOR THE APPLICATION TO BE ASSESSED, AND CARE SHOULD BE TAKEN TO ENSURE THAT THE DETAILS ARE FULL, ACCURATE AND RELEVANT TO THE REQUIREMENTS SET OUT FOR THE POST. IF THIS FORM IS SCANNED THE FORMAT AND CONTENT MUST REMAIN UNALTERED. ADDITIONAL SHEETS SHOULD NOT BE INSERTED NOR CURRICULUM VITAE ATTACHED. DATA PROTECTION NORTHERN IRELAND FIRE & RESCUE SERVICE PROCESSES THE INFORMATION PROVIDED ON THIS FORM FOR THE PURPOSES OF MEETING ITS LEGAL OBLIGATIONS. JOB REF NO: U010/07/2011 CANDIDATE NO: ASSESSMENT NO: NORTHERN IRELAND FIRE & RESCUE SERVICE 1 SEYMOUR STREET, LISBURN, BT27 4SX APPLICATION FORM FOR WHOLETIME FIREFIGHTER SURNAME FORENAMES ADDRESS Mr/Mrs/Miss/Ms/Or other title TOWN TELEPHONE NO NATIONAL INSURANCE NO POSTCODE PLEASE TICK APPROPRIATE BOX ARE YOU AN EC NATIONAL? DO YOU REQUIRE A WORK PERMIT TO WORK IN NORTHERN IRELAND? ARE YOU CURRENTLY EMPLOYED BY THE NORTHERN IRELAND FIRE & RESCUE SERVICE? IF YES, PLEASE STATE SERVICE NO ARE YOU TRANSFERRING FROM ANOTHER FIRE SERVICE IN THE UK? YES NO Wholetime Firefighter Ref: U010/07/2011 Page 1

2 EDUCATION Applicants must have a minimum of GCSE Maths and GCSE English Language Grades A-C (or equivalent). Please provide details of when you achieved your GCSE Maths and GCSE English Language. Qualification Grade Awarded By Year Awarded GCSE Maths GCSE English Language If you possess qualifications deemed of an equivalent level please provide the following details: GCSE Maths Equivalent: Qualification: Grade/Level: Awarded By: Year Awarded: GCSE English Language Equivalent: Qualification: Grade/Level: Awarded By: Year Awarded: Important: Where an applicant is relying on equivalent qualifications, it is the applicant's responsibility to provide evidence as to how their qualifications meet the required standard For Official Use only Qualifications Acceptable Yes No Assessor No: Wholetime Firefighter Ref: U010/07/2011 Page 2

3 SECTION 1 Thank you for expressing an interest in applying to Northern Ireland Fire & Rescue Service. Making an application will require quite a lot of time and effort from you. Before starting the application please complete the pre-application checklist. This will help you decide whether you are likely to enjoy working as a Firefighter and whether you are eligible to apply. Pre-Application Checklist Being a Firefighter is challenging and can involve a number of situations not commonly found in other jobs. Before completing this application form, take a moment to answer these questions. Are you prepared to: Work at height? Yes No Work in enclosed spaces? Yes No Work outdoors? Yes No Get wet during your work? Yes No Get hot/cold whilst working? Yes No Carry heavy equipment? Yes No Work unsociable hours? Yes No Work in situations where you may see blood, seriously injured, or dead people? Yes No Deal sensitively with people in difficult situations? Yes No Carry out prevention tasks? Yes No Talk to people in the local community about fire safety? Yes No If you have ticked the "no" box for any of the questions, we strongly suggest you think seriously about whether being a Firefighter is right for you. Wholetime Firefighter Ref: U010/07/2011 Page 3

4 SECTION 2 - ASSESSMENT OF PERSONAL QUALITIES AND ATTRIBUTES Guidance Notes for completion In this section, we ask you to tell us about your skills and experience in relation to the various Personal Qualities and Attributes (PQAs) that are required as a Firefighter. You may draw on any of your experiences to answer the questions from: home life, leisure activities, work (paid or unpaid), voluntary work or education. Please remember the following general points when completing this section: It is important that you answer every question. If you are completing the form in your own handwriting, please ensure that you write your answers neatly and legibly. Each question asks you to describe a specific situation about which you have had experience. For each of the 6 questions you should write about an example that best describes your experience in relation to the activities mentioned. Be specific about one activity that you do at the moment or have done, rather than writing in general terms. Use a specific example for each question where you have demonstrated the activity more than once. For each question describe the situation, what you did, why you did it and what happened as a result (using font size 10). Please use fairly recent examples (ie, within the last 3 years) of what you have done. It is a good idea to write/type out your answers in rough before you copy the final version on to this application form. Your answers must describe what you have done. If you provide false information your application will be rejected. Wholetime Firefighter Ref: U010/07/2011 Page 4

5 For each of the 6 questions below, give a short example of an activity you have done within the last 3 years that best illustrates your experience in this area. You may draw on your experiences at work, at home, or in your leisure time. 1 Working with people of different backgrounds, ages, or gender This question relates to the Firefighter PQA - Commitment to Diversity and Integrity - this means that you understand and respect diversity and adopt a fair and ethical approach to others. Please describe a situation where you have interacted with people who are different from you in terms of background, age or gender: What was the situation? What role did you play? What happened as a result? PQA Score Wholetime Firefighter Ref: U010/07/2011 Page 5

6 2 Building working relationships and working as a supportive team member This question relates to the Firefighter PQA - Working with Others - this means that you work effectively with others both within the Fire & Rescue Service and in the community. Please describe a situation where you have had to work closely with others as part of a team: What was the situation? What role did you play? What happened as a result? PQA Score Wholetime Firefighter Ref: U010/07/2011 Page 6

7 3 Taking steps to improve my skills and learn new things This question relates to the Firefighter PQA - Commitment to Development - this means that you are committed to and able to develop yourself and others. Please describe a situation where you have taken steps to improve your skills and/or learn new things: What was the situation? What role did you play? What happened as a result? PQA Score Wholetime Firefighter Ref: U010/07/2011 Page 7

8 4 Staying calm, confident and in control during difficult or stressful situations This question relates to the Firefighter PQA - Confidence and Resilience - this means that you maintain a confident and resilient attitude in highly challenging situations. Please describe a situation where you have had to remain calm and controlled in a stressful situation: What was the situation? What role did you play? What happened as a result? PQA Score Wholetime Firefighter Ref: U010/07/2011 Page 8

9 5 Completing an activity on my own according to guidelines This question relates to the Firefighter PQA - Commitment to Excellence - this means that you adopt a conscientious and proactive approach to work to achieve and maintain excellent standards. Please describe a situation where you have had to work on your own in accordance with guidelines: What was the situation? What role did you play? What happened as a result? PQA Score Wholetime Firefighter Ref: U010/07/2011 Page 9

10 6 Being open to change and actively supporting it This question relates to the Firefighter PQA - Openness to Change - this means that you are open to change and actively seek to support it. Please describe a situation where you have had to change the way you do something following a change imposed by someone in authority: What was the situation? What role did you play? What happened as a result? PQA Score Total Score Assessor No: Wholetime Firefighter Ref: U010/07/2011 Page 10

11 CURRENT EMPLOYMENT EMPLOYER'S FULL NAME AND ADDRESS POSITION HELD Give details of all previous employment since leaving school, including part-time employment: EMPLOYER'S FULL NAME AND ADDRESS POSITION HELD REASON FOR LEAVING Are you required to give notice to your present employer? YES NO If so, please state period of notice Wholetime Firefighter Ref: U010/07/2011 Page 11

12 DISABILITY Northern Ireland Fire & Rescue Service is committed to meeting its duties under the Disability Discrimination Act 1995 (the "DDA"). Under the DDA, a disability is defined as a "physical or mental impairment that has the substantial and long-term adverse effect on your ability to carry out normal day-to-day activities". Reasonable adjustments will be considered by Northern Ireland Fire & Rescue Service for those applicants who have identified a disability which may require a reasonable adjustment to be made. Northern Ireland Fire & Rescue Service welcomes applications from disabled persons who meet the selection criteria. If you have a disability please indicate any relevant effects of your disability and suggest adjustments which might help you to overcome any disadvantages you might expect to encounter in the recruitment process. This also includes Specific Learning Difficulties, eg, dyslexia, dyscalculia or dyspraxia. CANVASSING Canvassing of Northern Ireland Fire & Rescue Service Officers or Members of the NIFRS Board in any form, oral or written, directly or indirectly in connection with this appointment shall disqualify a candidate DECLARATION I declare that the information contained in this application form is correct to the best of my knowledge. I also accept that if I have provided false or misleading information this will render my application invalid and any appointment offered will be rescinded or terminated. SIGNED: DATE: Wholetime Firefighter Ref: U010/07/2011 Page 12

13 This information is required only in connection with interview arrangements and will not be attached with your application during the selection procedure. NAME APPLICATION FOR POST OF REFERENCE WHOLETIME FIREFIGHTER U010/07/2011 *I am not related to any Member(s) of the NIFRS Board or Officer(s) of the Northern Ireland Fire & Rescue Service. *I am related to the undernoted Member(s) of the NIFRS Board or Officer(s) of the Northern Ireland Fire & Rescue Service: (*Delete as appropriate) NAME POST LOCATION RELATIONSHIP FOR OFFICE USE ONLY POST: WHOLETIME FIREFIGHTER JOB REF NO: U010/07/2011 CANDIDATE NO: Wholetime Firefighter Ref: U010/07/2011 Page 13

14 EQUALITY MONITORING FORM Northern Ireland Fire & Rescue Service (NIFRS) is committed to equality of opportunity for all employees and job applicants, regardless of gender, marital status, disability, age, religious affiliation, political opinion, ethnic origin, dependants, or sexual orientation. NIFRS selects those suitable for employment and advancement solely on the basis of merit. NIFRS monitors its recruitment and selection activity to ensure that equal opportunities policy is effectively implemented. To assist in this monitoring process it is necessary to ask you a number of questions. Section A In order to comply with legislative requirements this section must be completed. Failure to complete Section A will result in your application being rejected. 1. Gender Male Female Transgendered 2. Marital status Single Married Separated Divorced Widowed Civil Partnered Civil Partner (dissolved) Co-habiting 3. Community Background and Religious Affiliation Employers registered with the Equality Commission for Northern Ireland have a legal duty to monitor community background under the Fair Employment and Treatment (NI) Order Regardless of whether we practice religion most of us in Northern Ireland are seen as either Catholic or Protestant. We are therefore asking you to indicate your community background by ticking the appropriate box below: I am a member of the Protestant community I am a member of the Roman Catholic community I am a member of neither the Protestant nor Roman Catholic community Do you have a religious affiliation or other belief? Yes If yes, are you: No Roman Catholic Presbyterian Church of Ireland Methodist Baptist other Christian denomination Hindu Jewish Buddhist Sikh Baha i Muslim Other please state Section B The following categories are monitored to promote equality of opportunity in accordance with equality legislation, and assess the extent of applicant and workforce diversity in NIFRS. 4. Political opinion Political opinion does not relate solely to Northern Ireland politics, you are invited to describe your political opinion in the manner you believe is appropriate and this can include how others would perceive or suppose your political opinion to be: Unionist Nationalist Other please state For Office Use Only Vacancy Ref No: U010/07/2011 Candidate No: Wholetime Firefighter Ref: U010/07/2011 Page 14

15 5. Ethnicity and Nationality Please tick the appropriate box to indicate your ethnic origin White Irish Traveller Chinese Indian Bangladeshi Pakistani Black-African Black-Caribbean Mixed Ethnic Group Any other ethnic group (please state) Please specify your nationality (please state) 6. Dependants Do you look after or give support on a daily/weekly/monthly basis to an individual belonging to one of the following groups: (a) a dependant child or young person Yes No (b) an adult with long-term physical or Yes No mental health problem (c) a dependant older person Yes No 7. Disability In accordance with the Disability Discrimination Act 1995, a disability is defined as a physical or mental impairment that has substantial and long-term adverse effect on your ability to carry out normal day-to-day activities'. Do you consider yourself to have a disability? Yes No If yes please specify the nature of your disability Do you have a Specific Learning Difficulty, eg, dyslexia, dyspraxia, dyscalculia? Yes No If yes please specify the nature of your difficulty 8. Age Please provide your Date of Birth 9. Please indicate your sexual orientation: Heterosexual Homosexual Bisexual Declining to comment When you have completed this monitoring form please place with your completed application form in an envelope addressed to the Equality Officer Please note: Your name must not appear anywhere on this form For Office Use Only POST: Wholetime Firefighter Vacancy Ref No: U010/07/2011 Candidate No: Wholetime Firefighter Ref: U010/07/2011 Page 15