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Section D

PART A: PERSONAL INFORMATION

Application for the position of:

Independent Assessor

Please read this guidance before completing your application.

This is the first part of a two part application form. Both parts must be completed before this application can be considered.

To ensure equality of opportunity for everyone, applicants must comply with the 400 word limit for each criterion. Additional information beyond this word limit will not be considered by the selection panel.

Both parts of this application form must be completed using Arial font size 12 or in legible block capitals using black ink.

The deadline for receipt of applications (including postal applications) is 12 noon on 25th May 2017. LATE APPLICATIONS WILL NOT BE ACCEPTED.

We advise you to retain a copy of your application.

IN CONFIDENCE (WHEN COMPLETED)

IN CONFIDENCE

1. Personal Details

Surname:

Title:

Forename(s):

Former surname(s) (if any):

Postal Address:

Postcode:

Telephone No. (incl STD code):

E-mail Address:

2. Disability (If you do not have a disability go to Section 3)

The Disability Discrimination Act 1995 defines disability as a physical or mental impairment which has a substantial and long term adverse effect on a persons ability to carry out normal day to day activities.

Do you consider that you have a disability?

The Commissioner for Public Appointments for Northern Ireland wishes to ensure that people with a disability are able to compete at interview on equal terms. The Commissioner will make any reasonable adjustment necessary to the interview process to make this possible. This could involve providing equipment, or practical assistance at an interview. It could also involve taking account of any feature of your disability which may affect your performance at interview and adjusting the interview process to ensure that you are not disadvantaged.

To ensure that reasonable adjustments can be made we would be grateful If you could:

a. Tell us the nature of your disability and what impact, if any, it may have on you during the interview process.

b. Tell us about any adjustments which you would wish to be made to the interview process in light of your disability.

c. Tell us about any reasonable adjustments you would like us to consider making which might help you to carry out the essential tasks of the post for which you are applying.

This information will help us to consider ways in which we can reasonably accommodate your needs. If you have difficulty completing this form, because of your disability, please contact the office of the Commissioner for Public Appointments for Northern Ireland (Telephone 028 9052 4820).

3. Other Information

How did you learn of this post?

Advertisement? Which Publication?

Elsewhere? Please specify:

4. Conditions

Only applications which contain all the requested information will be considered.

Before you submit your application, please ensure that you are eligible for this competition by referring to the Role Description, Person Specification and information about the process in the Information Pack.

A candidate found to have given false information or wilfully to have suppressed any material fact will be liable to disqualification or, if appointed, to termination of their agreement with CPA NI.

Late applications will not be accepted.

5. Declaration

The information given in Parts A and B of this application is complete and correct to the best of my knowledge.

Name:

Date:

If your application is submitted online we will require you to sign this form if invited to interview.

Please send your completed application to:

Commissioner for Public Appointments for Northern Ireland

Annexe B

Dundonald House

Stormont Estate

Belfast

BT4 3SB

E-mail: recruitment@publicappointmentsni.org

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PART B: SKILLS AND UNDERSTANDING

Application for the post of:

Independent Assessor

Before you complete Part B please ensure you have read the guidance on the front of Part A.

The selection panel will invite to interview only those applicants who appear to them, from the information provided here, to be the most suitable in terms of the skills and understanding asked for.

It is therefore essential that you give full details in each of the following sections, and provide evidence of how you meet the particular requirements sought, giving examples.

It is not enough simply to list the various posts that you have held. The selection panel cannot make assumptions as to the skills and understanding you have gained from the title and job description of previous posts held.

Supplementary material such as CVs or testimonials will not be considered.

It is your responsibility to demonstrate clearly on the Application Form how you satisfy the published essential and desirable criteria.

IN CONFIDENCE WHEN COMPLETED

1. Essential Criteria

Provide by way of examples evidence of how you communicate effectively verbally and in writing. (400 words)

Please provide detailed evidence of how you meet this criterion including specific examples.

Provide by way of examples evidence of your ability to build and manage relationships. (400 words)

Please provide detailed evidence of how you meet this criterion including specific examples.

Provide by way of examples evidence of your ability to work effectively as part of a team. (400 words)

Please provide detailed evidence of how you meet this criterion including specific examples.

Provide by way of examples evidence of your ability to influence opinions and outcomes and challenge constructively. (400 words)

Please provide detailed evidence of how you meet this criterion including specific examples.

2. Desirable Criteria

Provide by way of examples evidence of when you had to make a decision that required you to take into account the views of several other people not all of whom were in full agreement with it. (400 words)

Please provide detailed evidence of how you meet this criterion including specific examples.

Provide by way of examples evidence of your ability to manage a difficult situation within a tight timeframe. (400 words)

Please provide detailed evidence of how you meet this criterion including specific examples.

3. Public Appointments and Voluntary positions held

Please use the space below to provide details of any public appointments or voluntary positions held.

4. Conflicts of Interest and Integrity

Please see the Conflict of Interest leaflet for Independent Assessors enclosed in the Information Pack.

Do you believe that a potential or actual conflict of interest (real or perceived) may arise if you are appointed to the position of Independent Assessor?

YES/NO (delete as appropriate)

If Yes please describe

Independent Assessors must be people who understand, apply and are committed to the principle of probity and will perform their duties with integrity and honesty without personal or corporate gain. Are you aware of any potential or actual probity matter that may affect CPA NI or your own position if you are appointed as an Independent Assessor?

YES/NO (delete as appropriate)

If Yes please describe

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