application form eclo changed

8/6/2019 Application Form ECLO Changed

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RNIB application for employment pack(Positions for which a CRB check is required only)

Notes on completing your applicationWhere possible please email your application back [email protected] as this is our preferred format (althoughwe are happy to accept other formats).

Please note that when emailing your application a hand-writtensignature is not necessary.

IntroductionThe decision on who to invite for interview is based on theinformation provided in completed applications. Therefore, youshould use the application form to show how you meet therequirements of the job. Please note that we will only accept acurriculum vitae from applicants whose disability makes it difficultfor them to complete an application form. All applicants, however,need to show how they meet the person specification.

Job description and person specification

You should have received a job description and a personspecification with the application pack. The job description lists the

job title, salary, band, location, purpose and main tasks of the job.The person specification lists the knowledge, experience, skills andabilities that the successful applicant will need to perform the jobeffectively. The person specification is divided into what thesuccessful applicant must have (the essential criteria) and what it

would be helpful for them to have (the desirable criteria).


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Application form for employment

Please indicate your answers after the colons (:) in the applicationform.

Section 3. Meeting the person specification

This section of the application form is particularly important. Whencompleting your application you must show how you meet theperson specification rather than the job description. This is mosteasily done by taking each point in turn.

Remember, we can only decide to invite you for interview based on

the information provided in your application.

If you are going to send us your curriculum vitae (an optionavailable only to applicants with a disability), you still need toprovide information about how you meet the person specification inthe way outlined above.

If you would like help completing your application, please contactus before the closing date and we will be glad to help you.

Section 5. Specific requirements

Our equal opportunities policy includes our commitment to makingreasonable adjustments to meet the needs of applicants andemployees with disabilities.

In order to do this, there are some questions related to the needsof disabled applicants on the application form. This includes aquestion about any specific requirements you may have if you areinvited to interview.

Section 6. Criminal records

For appropriate positions it is RNIB's policy to obtain disclosuresfrom the Criminal Records Bureau. This process is initiated onlyonce an applicant has been given a conditional offer. Please findattached RNIB's policy on the recruitment of ex-offenders.


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Equal opportunities monitoring information

RNIB recruits and selects employees by using job-related criteria(the person specification). To ensure that this process is fair, we

need to find out how you found out about this vacancy. Also, wewould like information about your age, gender, marital status,ethnic origin, disability and in Northern Ireland only, religious belief.We then compare, anonymously, who applies, who we shortlist,and who we appoint, with information about the labour market.

Please complete the attached equal opportunities monitoringinformation form and return it with your application. Please notethat this information is separated from the application form before

shortlisting and interviewing.


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Application Form for Employment (CRB roles)

Confidential

1. Personal details

Forename(s) or given name: Adrienne Christine

Surname: Hull

Please state your preferred title (i.e. Mrs, Miss, Mr, Dr): Mrs

Position for which you are applying: Eye Care Liaison Officer

(temporary maternity cover)

Location: Belfast

Vacancy reference number: 5824

Home address: 37 Princetown Rd, Bangor, Co.Down

Postcode: BT20 3TA

Telephone (home):028 91453246

Telephone (mobile):07717480141

If you are happy for us to contact you at work:Telephone (work): N/A

Email: [email protected]


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2. Present and previous occupations

Please give full details of all previous occupation(s), explaining anygaps. Please start with current or most recent. (Include the

information requested below for each position you have held).

Currently unemployed at moment.

Employer's name and addressQuintiles Ltd,Ringside,79 High St,Bracknell,

Berkshire RG12 1DZ

August 2010 - November 2010Medical Sales Representative (Temporary Fixed termappointment)

Working for Quintiles on behalf of Astellas Transplant TeamResponsible for calling on health care professionals to highlight theimportance of brand prescribing for transplant patients to ensurepatient safety.

Salary: 30,000

Reason for leaving: Short term contract finished

Employer's name and address:

Merck Serono Ltd, Gastroenterology DivisionBedfont Cross, Stanwell Rd, Felthem, Middlesex TW14 8NX

November 2008 - May 2009

Key account Manager: (covering long term sick leave)

Responsible for promoting and supporting healthcare professionalsin the usage of enteral feeding devices and accessories, training

and updating hospitals consultants and their teams on changes toenteral feeding tubes.


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Salary; 30,000 (4 day week)

Reason for leaving: Employee on long term sick leave returned

to work.

Employer's name and address:Merck Serono Ltd, Bedfont Cross,Stanwell Rd,Feltham,Middlesex TW14 8NXOctober 2004 - May 2008

Medical Sales Representative,

Responsible for promoting and developing business for bothcardiovascular and diabetic products to primary and secondarycare health care professionals which included diabetic specialistnurses, practice nurses, hospital and community pharmacists.

Salary: 38,000 Full Time

Reason for leaving : Redundancy

Employers name and address:Takeda UK LtdTakeda House ,Mercury Pk, Wycombe lane, Wooburn Green, HighWycombe, Buckingham. HP10 OHH

January 2000 - September 2004

Medical Sales Representative:

Responsible for promoting cardiovascular and diabetic productsand services to medical professionals and customer groups.Salary: 36,000 Full time

Reason for leaving: Redundancy


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Employers name and address:

Rhone Poulenc Rorer Ltd Change name to Sanofi Aventis1 Onslow St, Guildford, Surry GUI 4YS

August 1984 November 1999

Responsible for selling products of multi-national pharmaceuticalcompany to consultant, GPs, Hospital and community pharmacist.

Salary; 28,000

Reason for leaving: Redundancy

Employers name and address:

South Eastern Health and Social Care TrustArds Hopspial, Church St, Newtownards, Co. Down BT23 4AS

September 1975- 1984State Enrolled Nurse:

Responsible for Patient Care, collaborate with other members of

health care team , protecting patients ensuring they are safe andhealthy and preventing the spread of infection.Salary; 10,000

Reason for leaving: Career change


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3. Meeting the person specification

This section is particularly important. Please explain below howyou meet the requirements of the person specification rather than

the job description. This is most easily done by taking each point inturn.

Where there is a requirement for a relevantqualification/membership of any professional bodies, pleasespecify the name of awarding body and the date awarded. Pleasenote that you will be required to provide evidence of these shouldyou be called to interview.

Before completing this section please read the "Notes oncompleting your application":

Person specification:

1. Specialist knowledge and experience;1.1 Knowledge of a wide range of eye conditions, their

treatments and the sources of support available

I have a very good knowledge of a wide range of eyeconditions from my training on the ECLO course inBirmingham. The most common eye conditions inNorthern Ireland are: Macular Degeneration, Cataract,Diabetic Retinopathy, Retinitis Pigmentosa andGlaucoma I have a good understanding of theirtreatments and the sources of support available bothlocally and throughout the UK.

With my nursing and pharmaceutical background I haveexperience of communicating effectively with peoplewith sight loss.


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1.2 Knowledge of social work and health servicesand functions of the health service and thefunctions of professionals within the eye healthfield.

I understand the role of the Sensory Support Teamwithin a patients sight loss journey. Support availablefrom Social Workers includes coming to terms with sightloss; Rehabilitation Workers provide practical support foradvice about lighting, specialist aids and mobility.

I have shadowed two different eye clinics at the MacularService and the Ulster Hospital, I have met the staff andunderstand their role from the Vision Nurse, Optometrist,Consultant Ophthalmologist and Orthoptist.

I am attending the ECLO in Birmingham at the moment,and I understand the Importantance of social workers

and health services is support patients in to coming toterms with condition, whether they are depressed needrehabilitation, as ECLO volunteer referral to appropriateservice.

1.3 Knowledge of current and potential servicesavailable to people with sight loss and relevantstandards.

RNIB NI services include: Benefits Advice Service, ITtraining, Employment advice and support, Children andfamily support, holiday chalet at Share Centre,Community Vision Co-ordinators and Resource Centre.RNIB also offer talking book service, counselling serviceand book club.


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Services available outside of RNIB include: Guide Dogsfor the blind, Deafblind UK, Sensory Support Team,Rehabilitation and Social Workers, Citizens AdviceBureau, Age NI, Low Vision Clinic, Torch Trust.

Standards include RQIA, NICE guidelines for glaucomatreatment.

1.4 Experience of working in an ECLO role orcommunity based social/health care services as a

direct service provider and knowledge of currentservice provision.

A: I have spent time with Lee Topley, and ClairBowes, observing their role. At Macular clinic atMater hospital Belfast I sat in on eye screening,Consultant and optometrist consultation, andinjections. I have extensive knowledge of currentservice provision within RNIB and external

agencies.

1.5 Experience and understanding of the need toinvolve service users and carers in the planning ofcare packages and/or service development.

The success of any service requires consultationwith service users; this may include feedback/

questionnaires or involvement in userforums/steering group.

I have experience in working one to one, planningand agreeing outcomes.

1.6 Experience and evidence of information gathering

and of guiding service users in the use of this


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information. I recently worked on a transplant team,highlighting the effect of branded prescribing asopposed to generic prescribing on the grounds ofpatients safety. My contact were mainly GPs andpractice managers.

1.7 Experience and evidence of providing emotionalsupport and advice in a health or social caresetting.

1.8 Experience of the preparation and delivery of

presentations in a clear and concise manner.

My career in sales has prepared me well for doingpresentation to groups of healthcare professionals. Ihave used Powerpoint for presentation and haveadapted my style and method of presentation to suit theaudience.

2. Communication

2.1 Ability to communicate clearly and effectively in astructured way and with a range of individuals, bothverbally and in writing.

Communication is very important for people withsight loss, knowing which format is required suchas large, clear print, audio, digital or Braille.

2.2 Ability to have empathy with and support to serviceusers whilst remaining objective.

As a nurse I used my skills to provide patients withsupport and understand my role in providing caringservices while remaining objective.


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3. PersuasivenessTo be able to motivate and stimulate other professionaldisciplines to respond to the social needs of people withsight loss.My experience in sales has allowed me to communicatewith a wide range of customers in persuading them to usemy product, over the years I have evidence to show I wasthe top sales person within the company.

4. OrganisationAbility to organise time effectively, create work schedules,prioritise work load and meet deadlines.

I am a very organised person, when I have a task tocomplete I break it down into manageable parts, priortisemy workload and plan a methodological way to meet mydeadlines.

For example in my last role as (put in here a time whenyou used the above skills to successfully complete a task)A: Very important to keep accurate account of serviceuser and service delivery record, do monthly reports.

5. Personal drive, commitment and resilienceAbility to adapt to suit changing circumstances and be

self-motivated to achieve objectives.

Again, use an example of meeting sales target one thatincludes obstacles and changing your approach to meetthe objective.

A: To ensure that I provide advice, support andinformation to users and families/ carers to cope with

Emotional, psychological, social, economic and any other


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difficulties that may arise from their diagnosis of their eyeconditions. To be adaptable with each patient.

6. Equal opportunitiesAbility to understand and demonstrate commitment toRNIBs Equal Opportunities Policy and to ensure allactivities are consistent with the Equal Opportunities

Say something like I have read and understand the RNIBs Equalopportunities policy. I do not discriminate against a personregarding of age, sex, disability, social standing, race, sexualorientation or religion.


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4. This section should be completed by applicants forteaching posts in RNIB

Please confirm:

Your DCFS (formerly DfES) reference number:Date probation cleared:Whether you have Qualified Teacher Status (QTS) Y/N:Whether you are registered with the General Teaching Council(GTC) for England Y/N:

5. Registration with a professional body?

Where there is a requirement in the person specification formembership of any professional bodies, please specify:

Registered body:Registration number:Date of registration:

6. Relevant qualifications?

Where there is a requirement in the person specification for arelevant qualification, please specify:

Qualification: State Enrolled NurseName of awarding body: Northern Ireland council for nurses andmidwivesDate awarded: 1979

7. Specific requirements

Please indicate your preferred reading format - Braille/Audiotape/Disk/Print/Email/Large Print (if large print, please specify printsize):printIf you were shortlisted for interview, would you have any specificrequirements related to your disability such as timing, wheelchairaccess or the presence of an interpreter, signer or other? Pleasespecify:


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Please state any dates or times, which you wish to avoid forinterview:

Where possible we will try to accommodate this, but interviews will

be conducted during office hours.

8. Have you ever been convicted of a criminaloffence?

The exemptions to the Rehabilitation of Offenders Act 1974 requirethat all spent or unspent convictions must be declared byapplicants for certain posts in RNIB, such as those that involvecontact with children or vulnerable adults. For information on the

position you are applying for please see the job description andperson specification. Further information can be found atwww.disclosure.gov.uk

Do you have any criminal convictions, cautions or bind overs?

Please specify yes or no: No

(Declaration subject to the Rehabilitation of Offenders Act 1974)

If your answer is yes, please give details of date(s) of offence(s)and sentence(s) passed and enclose in a separate envelopemarked confidential.

9. Are you currently named on List 99, the POVA orPOCA check lists, disqualified from work withchildren or subject to sanctions imposed by aregulatory body such as The General TeachingCouncil?


If your answer is yes please provide details in a separate envelopemarked confidential.

10. Are you aware of any health reason that wouldprevent you from carrying out the full duties of thispost?


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If your answer is yes please provide details in a separate envelopemarked confidential.

11. Have you ever worked for RNIB?

Please specify yes or no: NO

If yes, please provide details of the date, role, location and reasonfor leaving:

12. If selected when would you be available to take up

employment with RNIB?

Please specify: August 2011

The Asylum and Immigration Act makes it a criminal offence toemploy a person who is not entitled to live or work in the UnitedKingdom. All successful applicants will be asked to producedocumentary evidence to support this before employment.

13. References

All offers of employment are subject to receipt of satisfactorywritten references. Please provide the names, addresses andtelephone numbers of two referees, one of whom should be yourpresent or most recent employer or an academic referee if moreappropriate. If you have previously held a post working withchildren or vulnerable adults then at least one of your referencesshould be from the most recent such employment.

Referees will not be contacted without your prior permission.

Name:Graham AtheyPosition: Project DirectorAddress:Quintiles Ltd, Ringside 79 High St, Bracknell, BerkshireRG12 1DZTelephone:01344708000Email: [email protected] is your connection with this referee? Head of project involvedin.May we approach this referee prior to interview? Yes


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The recruitment of ex-offenders - RNIB policy

RNIB's Equal Opportunities policy guarantees that all paid andunpaid work opportunities are open to all members of the

community who wish to apply for them.

Every job/volunteer pack issued by RNIB contains this policystatement indicating our willingness to consider ex-offenders foremployment or volunteering.

It is RNIB policy to seek a Criminal Record Disclosure from anexisting or potential staff member or volunteer where the role heldor sought involves a degree of risk. In RNIB this is particularly

relevant where children and other vulnerable groups areconcerned.

These checks or disclosures are carried out through the CriminalRecords Bureau (CRB), a Government agency.

It is not RNIB's policy to use disclosure as a blanket requirement inall circumstances. A disclosure will only be obtained once aconditional offer has been made. It is RNIB's policy to inform at the

outset if criminal record information is required from potential staffor volunteers. This provides a basis for applicants to decidewhether or not to apply. It is also our policy only to use criminalrecord information in so far as it is relevant; applicants will beconsidered on merit and ability and not discriminated againstunfairly. We are conscious that to do otherwise may encourageapplicants to lie about their criminal record.

We undertake to ensure that disclosure information we receive isstored securely and is only available on a need to know basis.

This policy is backed by RNIB's "Code of Practice on Disclosure",which is available to applicants on request.


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Equal Opportunities Policy

RNIB is committed to being an equal opportunities organisation.This policy applies to RNIB's governance, service delivery,

employment and volunteering practices. Contractors, andorganisations that we work in partnership with, are also expectedto abide by this policy. This policy covers RNIB's operationsthroughout all of the United Kingdom.

We define equal opportunities as:

the removal of direct discrimination - ensuring that people arenot treated less favourably on the grounds of their disability,ethnicity, national origin, colour and race, sex, gender

reassignment, marital status, religious belief and politicalopinion, sexual orientation, age (please note: there are someposts where insurance cover requires post-holders to be acertain age for cover to be valid, for example, driving posts) ortrade union membership/non-membership

the removal of indirect discrimination - ensuring requirements orconditions do not unfairly or unjustifiably limit access toservices, jobs or volunteering opportunities

equal rights - the achievement and respect of equal civil rights

for all equal access - increasing access to services, volunteering or

job opportunities by having policies and practices which takeaccount of diverse needs

positive action - action that targets groups which are under-represented within our customers, workforce or volunteers. Theaim is to increase under-represented groups access to RNIB.For example, if Asian people were under-represented ascustomers, we might choose to publicise our services in Asian

newspapers.

Equality is one of RNIB's core values. As such, it forms part of theframework within which other policies, procedures and practiceswithin RNIB are to be developed and implemented.


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Disability equality

RNIB, as a disability organisation, recognises the exclusion anddisadvantages that people with disabilities experience as a result

of social, economic and material barriers, created by the world inwhich they live. RNIB also recognises that people with disabilitiesmay be enabled by learning additional skills.

RNIB is working to ensure that people with disabilities receive themaximum possible benefit that can accrue to them through theDisability Discrimination Act (DDA). RNIB will, at the very least,take steps to ensure that it meets its obligations under the DDAand, where possible, exceeds them. This includes making

reasonable adjustments to meet the needs of trustees, committeemembers, job applicants, employees, customers and volunteers,who may have a disability.

RNIB is further committed to positive action, in terms of ouremployment of blind and partially sighted people. We will also usepositive discrimination - where two candidates equally meetselection criteria at interview, where one of the candidates is blindor partially sighted, then she or he should be offered the post. The

DDA allows charities, which promote the interests of a particulargroup of disabled people, to treat people from that group morefavourably than others where this is connected with their charitablepurposes.


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Equal Opportunities Monitoring Information

Confidential

Please complete the following form and return with your completedapplication form.

Please refer to the section "Equal opportunities monitoringinformation" in "Notes on completing your application", which isattached in the information pack, before completing this form. Theinformation which you supply on this form will be separated fromthe application form prior to shortlisting.

Please complete all questions by ticking the appropriate responseor entering the information requested.

Name:

Vacancy reference number:

Vacancy applied for:

How did you hear about this vacancy? Please delete optionsthat are not appropriate:

Advertisement in newspaper (please specify):

Advertisement on RNIB website:

Advertisement on other website (please specify):

Through job centre:

Through an employment agency (please specify):

From friend/relative/colleague:

RNIB's internal vacancy list:

RNIB's freephone vacancy line: Other (please specify):

Date of birth:

Age:

Gender: Male/Female (please specify):

Marital status: Single/Married/Other (please specify):


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From the list that follows, please indicate how you prefer todescribe your ethnic origin. Note, these are the categoriesrecommended by the Commission for Racial Equality.Choose ONE section from A to E, then write yes next to the

relevant description to indicate your cultural background.

A. White:

1. British:

English:

Scottish:

Welsh:

Other, please write in:

2. Irish:

3. Any other White background, please write in:

B. Mixed:

White and Black Caribbean:

White and Black African:

White and Asian:

Any other Mixed background, please write in:

C. Asian, Asian British, Asian English, Asian Scottish, or AsianWelsh:

Indian:

Pakistani:

Bangladeshi:

Any other Asian background, please write in:

D. Black, Black British, Black English, Black Scottish, or BlackWelsh:

Caribbean:

African:

Any other Black background, please write in:

E. Chinese, Chinese British, Chinese English, Chinese Scottish,Chinese Welsh, or other ethnic group:

Chinese:

Any other background please write in:


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For employment purposes, a person with a disability is identified assomeone with a physical, sensory or mental impairment that has asubstantial and long-term adverse effect on his or her ability tocarry out normal day-to-day activities.

For employment purposes, do you have a disability? Pleasespecify yes or no:

If yes, from the options that follows, please indicate whichbest describes your disability. Please delete the option that isnot appropriate:

Sight loss

Other disability

To be completed by applicants applying for positionsin Northern Ireland only

We are an equal opportunities employer. We do not discriminateon grounds of religious belief or political opinion. We practiseequality of opportunity in employment and select the best personfor the job.

To demonstrate our commitment to equality of opportunity inemployment we need to monitor the community background of ouremployees, as required by the Fair Employment and TreatmentOrder 1998.

Regardless of whether we practise religion, most of us in NorthernIreland are seen as either Catholic or Protestant. We are thereforeasking you to indicate your community background selectingthe appropriate category below. Please delete options that are

not appropriate: 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 or Roman CatholicCommunity.

If you are not indicating either Protestant nor Roman Catholicplease give details of the primary school you attended in NorthernIreland:


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Note: It is a criminal offence under Fair Employment legislation fora person to "give false information ... in connection with thepreparation of the monitoring return".

application form eclo changed

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