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Westmeath County Council Aras an Chontae, Mullingar, County Westmeath Tel: (044) 93 32000 Web: www.westmeathcoco.ie e-mail: [email protected] APPLICATION FOR THE POST OF: STAFF OFFICER IMPORTANT CHECKLIST AND NOTES: This application form should be submitted fully completed to the Human Resources Section, Westmeath County Council, Áras an Chontae, Mullingar not later than 4.00pm on Friday, 3rd May 2019. Responsibility rests with the applicant to ensure the application form, in full, is received on time by the Human Resources Department of Westmeath County Council. Please do not submit a CV with this application . You may also return this application form in Word format by email to [email protected] so as to arrive not later than the above closing date and time. Candidates who send their application by post should allow sufficient time to ensure delivery not later than the latest time for acceptance. Allegations that any application form or letter relating to it has been lost or delayed in the post will not be considered by the Council unless a Post Office Certificate of Posting is produced in support of such allegations. Responsibility to make contact with An Post regarding any delays rests with the applicant. Before you return the form please ensure that you have completed all sections and that you have signed the declaration at the end of the form. Where an application is submitted by e-mail, candidates shortlisted for interview will be requested to sign the declaration. You should satisfy yourself that you are eligible under the criteria set out for the position. The Council cannot undertake to investigate the eligibility of candidates in advance of the interview and hence persons who are ineligible, but nevertheless enter, may thus put themselves

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Westmeath County Council

Aras an Chontae, Mullingar, County Westmeath

Tel: (044) 93 32000 Web: www.westmeathcoco.ie e-mail: [email protected]

APPLICATION FOR THE POST OF: STAFF OFFICER

IMPORTANT CHECKLIST AND NOTES: This application form should be submitted fully completed to the

Human Resources Section, Westmeath County Council, Áras an Chontae, Mullingar not later than 4.00pm on Friday, 3rd May 2019.

Responsibility rests with the applicant to ensure the application form, in full, is received on time by the Human Resources Department of Westmeath County Council. Please do not submit a CV with this application.

You may also return this application form in Word format by email to [email protected] so as to arrive not later than the above closing date and time.

Candidates who send their application by post should allow sufficient time to ensure delivery not later than the latest time for acceptance. Allegations that any application form or letter relating to it has been lost or delayed in the post will not be considered by the Council unless a Post Office Certificate of Posting is produced in support of such allegations. Responsibility to make contact with An Post regarding any delays rests with the applicant.

Before you return the form please ensure that you have completed all sections and that you have signed the declaration at the end of the form. Where an application is submitted by e-mail, candidates shortlisted for interview will be requested to sign the declaration.

You should satisfy yourself that you are eligible under the criteria set out for the position. The Council cannot undertake to investigate the eligibility of candidates in advance of the interview and hence persons who are ineligible, but nevertheless enter, may thus put themselves to unnecessary expense. Candidates attend for interview at their own expense.

Please note that you may be asked to provide evidence of the National Framework of Qualifications level of your qualifications and copy certificates verifying qualifications and/or transcripts. The onus is on candidates to establish eligibility in this application form.

Copies of certificates are required to be submitted with the application form.

Applications may be short-listed on the basis of the information provided on the application form and it is expected that given the qualifications and experience of prospective applicants that the short-listing requirements will be significantly higher than the minimum qualifications and experience requirements set out for the post.

Canvassing by or on behalf of the applicant will automatically disqualify.

Westmeath County Council

Westmeath County Council is one of 31 local authorities in the republic of Ireland. The Council has responsibility for the delivery of a wide range of services which are necessary to the physical, economic, social and cultural life of County Westmeath, with a focus on making Westmeath an attractive place to live, work and invest.

The following comprise the areas of service in Westmeath County Council:-

Economic & Community Development Local Enterprise Planning Cultural & Recreational Services Infrastructure Water Services Housing Fire & Emergency Services Environment Finance Information Services Corporate Services Human Resources

This is an opportunity to gain employment with Westmeath County Council in the role of Staff Officer.

Westmeath County Council is committed to a policy of open and fair recruitment, in line with good practice, recruitment and selection standards, employment legislation and relevant circulars from the Dept. of Housing, Planning, & Local Government.

This Candidate Information Booklet is intended to provide information on the post of Staff Officer and the selection process and candidates are advised to familiarise themselves with the detailed information in advance of submitting their application.

Candidates should satisfy themselves that they are eligible under the Qualifications to apply for the post of Staff Officer.

Where a candidate provides false or misleading information or has deliberately omitted relevant information on their application form this may result in their disqualification from the competition.

Westmeath County Council

Job Specification

Staff Officer - Grade V

Introduction:The Staff Officer is a frontline supervisory position in the Council with responsibility for managing the performance of a section or function within a Department. He/She will work as part of a multidisciplinary team within the Council, assisting with the implementation of work programmes to achieve goals, targets and standards set out in Departmental and Team development plans. A Staff Officer is expected to use initiative, work to a high standard and have excellent interpersonal and communication skills.

THE IDEAL CANDIDATE:In the context of key duties and responsibilities for the post of Staff Officer, the ideal candidate will demonstrate the following knowledge, skills and competencies:

knowledge of the structure and functions of local government, of current local government issues, and of the key influencers of local government;

an understanding of the role of Staff Officer;

an understanding of the representational role of the elected members and the need to work with them to deliver quality services and implement policy decisions;

an ability to supervise a team effectively to achieve a common goal, ensuring strong governance and ethics standards are adhered to and maintained;

an ability to motivate and encourage staff under his/her control to achieve maximum performance by supporting the current Performance Management and Development System (PMDS);

a career record that demonstrates an ability to supervise staff; relevant administrative experience and input to delivery of organisational

objectives;

proven management report writing and analysis skills;

an ability to work under pressure to tight deadlines in the delivery of key operational objectives;

be self motivated with ability to work on own initiative;

have strong interpersonal and communications skills and be capable of representing the Council in a professional and credible manner with all stakeholders;

have an awareness of Health and Safety Legislation and Regulations, the implications for the organisation and the employee, and their application in the workplace.

Main Duties and Responsibilities:

1. Supervision of employees in supporting roles up to position/grade of Assistant Staff Officer, including assigning duties and workload;

2. Supporting the Senior Staff Officer in the implementation of work programmes as required by the Council's Corporate and Operational Plans;

3. Supporting the Senior Staff Officer to communicate, implement and manage all change management initiatives within the relevant area of responsibility;

4. Responsibility for the supervision of a section or function within the Council;

5. Delivery of specific departmental/organizational objectives;

6. Manage conflicting demands within a team environment and to prescribed timelines and deadlines;

7. Provide ongoing motivation and support to employees in the department/section including resolving day to day problems and identifying training and development requirements as appropriate;

8. Ensure full compliance with all organisational policies and procedures including grievance and disciplinary, performance management and attendance management;

9. Communicate and liaise effectively with colleagues, managers and customers in relation to operational matters for their section;

10. Compile, prepare and present reports as necessary, including preparation of reports or letters, which may be of a sensitive and/or confidential in nature;

11. Support implementation of good practices with transparent reporting and communications and to deliver accountable services in the department/section;

12. Carry out duties in a manner that enhances public trust and confidence and ensures impartial decision making;

13. Preparing Team Plans and conducting PDP meetings.

14. Such other duties as may be assigned from time to time

The particular duties and responsibilities attached to the post may vary from time to time, without changing the general character of the duties or level of responsibilities entailed. The post holder may therefore be required to perform duties appropriate to the post, other than those detailed above, and to take instructions from and report to, an appropriate Officer or such designated Officer as may be assigned from time to time by the County Council.

Staff Officer

QualificationsThe declared qualifications for the post of Staff Officer are as set out hereunder:

Qualifications for Panel A (Common Recruitment Pool)

1. CharacterCandidates shall be of good character.

2. HealthEach candidate must be in a state of health such as would indicate a reasonable prospect of ability to render regular and efficient service.

3. Education, Training, Experience, etc.Each candidate must, on the latest date for receipt of completed application forms - (a) be a serving employee in a local authority, health board, vocational

education committee in the State, institute of technology, the General Medical Services (Payments) Board, St. James's Hospital Board, Beaumont Hospital Board, An Bord Altranais, the Local Government Computer Services Board, the Border, Midland and Western Regional Assembly or the Southern and Eastern Regional Assembly and have satisfactory experience at a level not lower than that of Assistant Staff Officer;

(b) have not less than two years satisfactory experience either in that post or at a level not lower than that of Clerical Officer in one of the organisations set out in paragraph (a) above;

(c) possess a satisfactory knowledge or experience of office organisation

Qualifications for Panel B (Open Competition)

1. CharacterCandidates shall be of good character.

2. HealthEach candidate must be in a state of health such as would indicate a reasonable prospect of ability to render regular and efficient service.

3. Education, Training, Experience, etc.a) possess a good standard of education andb) have proven and relevant experience in administrative

procedures including practical experience in work on an administrative nature, office organisation and control of staff;

c) Possess a satisfactory knowledge of the functions and duties of local authorities and;

d) Possess a satisfactory knowledge or experience of office organisation

Staff Officer

Particulars of Employment

1. The PostThe post is wholetime and permanent. A panel will be formed from which full time posts may be filled.

2. LocationWestmeath County Council reserves the right to assign the successful candidate to any premises in use by the Council, now or in the future.

The person appointed will be required to report to their place of work by their own means of transport and at their own expense.

3. CommencementWestmeath County Council shall require a person to whom an appointment is offered to take up such appointment within a period of not more than one month and if they fail to take up the appointment within such period or such other longer period as the Council in its absolute discretion may determine, Westmeath County Council shall not appoint them.

4. Working HoursThe successful candidate needs to be aware of the fact that the post may not consist of nine to five thirty Monday to Thursday and nine to five on Friday, but may require evening work and weekends. Also the successful candidate may be required to travel as part of their work.

All hours worked are subject to and recorded in accordance with the provisions of the Organisation of Working Time Act, 1997, and the Organisation of Working Time Regulations 2001.

5. Reporting ArrangementsThe successful candidate will be required to report to the employee(s) designated by the Chief Executive.

A system of regular appraisal will be operated during employment, which will involve discussions between the employee and the line manager regarding performance and conduct.

6. Probationary Period of EmploymentThere shall be a period after appointment during which you will hold the post of Staff Officer on probation. The probation period shall be one year, however the Chief Executive may at his/her discretion extend this period of probation. If your service is deemed unsatisfactory within the probationary period you will cease to hold the position.

Please note that tenure of employment will be subject to satisfactory service on an ongoing basis.

7. RemunerationThe current salary scale for the post of Staff Officer is €42,041 - €50,490 gross per annum (EL 04/2018). On appointment the candidate will be placed on the appropriate point of the salary scale in accordance with the relevant Circular.

Remuneration is paid fortnightly by PayPath directly to the employee’s

nominated bank account. The current wage pay cycle may be revised during the period of employment.

Remuneration is subject to all statutory deductions e.g. PAYE and PRSI. Increments are paid annually subject to satisfactory attendance, conduct and performance and national agreements. Increments may be withheld if performance, attendance and/or conduct are not satisfactory.

8. Superannuation and RetirementA person who becomes a pensionable employee of the County Council will be required in respect of their Superannuation to contribute to the Local Authority at the appropriate rate.

The terms of the Local Government Superannuation (Consolidation) Scheme 1998 as amended or the Public Services Superannuation (Miscellaneous Provisions) Act 2004 or the Public Service Pensions (Single Scheme & Other Provisions) Act 2012 will apply as appropriate on appointment.

The maximum retirement age for employees is 70 years.

9. Annual LeaveThe current annual leave entitlement for Staff Officer is 30 days per annum, in accordance with the Council’s Annual Leave Policy.

The Chief Executive of Westmeath County Council retains autonomy with regard to office closures (e.g. Christmas Office Closure), any days arising from such closure will be reserved from the employee’s annual leave entitlement. Proposed office closure days will be reviewed and advised to all employees each year.

10. Driver’s Licence & InsuranceYou may on occasion be required to use your car on official business. In such situations you must hold a current clean driver’s licence and have available adequate means of transport. It is your responsibility to arrange insurance cover for business use and to indemnify Westmeath County Council with the indemnity specified on your insurance certificate under the heading “Persons or classes of person who are covered”.

If, during your employment, your licence is revoked, even temporarily, or if you receive endorsements on your licence which may affect your duties you are obliged to notify the Council immediately.

11. Code of Conduct/Organisation PoliciesEmployees are required to adhere to all current and future Westmeath County Council codes of practice including Code of Conduct of Employees and all current and future organisational policies including, but not limited to Health and Safety, Communications, Data Protection, Equality, Staff Mobility, Attendance Management and Use of Electronic Equipment.

12. TrainingEmployees are required to attend and participate fully in training programmes as may be decided by the County from time to time and to apply their learning in the course of their daily working activities.

13. Health & Safety RegulationsWestmeath County Council as an Employer is obliged to ensure, so far as it is reasonably practicable the Safety, Health and Welfare at Work of all its employees. Under the Safety, Health and Welfare at Work Act 2005, the County Council has a legal duty to exercise all due care and take all protective and preventative measure to protect the Safety, Health and Welfare of its employees.

All employees also have a legal obligation under Safety and Health legislation to co-operate with management and not engage in any improper conduct or behaviour or do anything which would place themselves or others at risk. Employees must not be under the influence of an intoxicant at the place of work.

Employees must comply with all Safety and Health rules and regulations and attend all required Safety and Health Training.

Important Notice

The above represents the principal conditions of service and is not intended to be the comprehensive list of all terms and conditions of employment which will be set out in the employment contract to be

agreed with the successful candidate.

STAFF OFFICER THE SELECTION PROCESS

1. How To Apply:

Only fully completed application forms will be accepted.

Please ensure that:

(i) Your application is made on the official application form only – CV’s should not be included. Note: your CV will not be accepted as an application or as part of your application.

(ii) You have fully completed all sections of the application form and included all relevant, detailed and accurate information. Note: any offer of employment is subject to the information given on your application form being true. False/misleading information or deliberate omissions may result in termination of employment.

(iii) You attach a copy of your educational certificates.

(iv) You submit your application on or before 4.00pm on 3rd May 2019.

Your completed application form should be emailed to [email protected] or sent by post to:-

Human Resources Department,Westmeath County Council,

Áras an Chontae,County Buildings,

MullingarCo. Westmeath.

NOTE: Applications submitted after the closing date will not be accepted.

Claims in relation to the late receipt of application forms will not be entertained unless supported by a certificate of evidence of postage from the appropriate postal authority.

The admission of a person to this competition, or an invitation to take tests or attend for interview is not to be taken as implying that Westmeath County Council is satisfied that such person fulfils the requirements.

You should receive an automated acknowledgement of your email from the Human Resources Department, if you do not receive the email you should contact the Human Resources Department at [email protected]

Westmeath County Council may need to contact you during the selection process. It is important that your contact details (phone number, postal and email address) as given on your application form are accessible by you at all times. Westmeath County Council accepts no responsibility for communication not accessed or received by an applicant.

2. Selection Process:Westmeath County Council reserves the right to shortlist applications as required.

This is not to suggest that any candidate may be unsuitable or incapable of undertaking the duties of post advertised, but rather that there may be candidates who have demonstrated that they are better qualified and/or have more relevant experience.

Step 1 – Initial ScreeningIn the first instance, all applications received by the latest date/time for receipt of completed applications are screened for eligibility in accordance with the declared Qualifications for the post. Applicants who possess the require eligibility criteria will progress to the Step 2 of the selection process.

Step 2 – ShortlistingEach candidate’s application will be assessed against pre-determined criteria based on the requirements for and duties of the post of Staff Officer. It is very important that the applicant provides a detailed and accurate account of their qualifications and experience on the application form.

Step 3 – InterviewCandidates who are shortlisted in Step 2 of the selection process will be invited to attend for interview(s).

An independent interview board will be established by the Chief Executive of Westmeath County Council to assess the candidates shortlisted for interview.

The interview board will generally comprise a Chairperson and two other members, who have expert knowledge in the relevant field. The objective of the interview board is to identify candidates who best meet the objective criteria and competencies required for the position and to place them in order of merit.

Westmeath County Council will endeavour to give sufficient notice of interview dates/times to shortlisted candidates. Thereafter, it is the responsibility of the candidate to ensure their availability on the date(s) and on time advised for interview(s). Expenses incurred in attending for interview(s) will be at the candidates own expense.

Candidates who are successful in the interview will be qualified for appointment to the post of Staff Officer and placed on a panel from which the vacancy will be filled.

It should be noted that placement on a panel does not necessarily lead to a job offer.

The selection process is not concluded until such time as references have been sought and clearance checks, i.e. Garda Vetting, Occupational Health, verification of education qualifications, etc., have been carried out to the satisfaction of the Council.

Should a candidate decline an offer of employment, or having accepted an offer of employment relinquish it prior to commencing in the post, they will be deemed to have withdrawn their application from the competition.

3. FeedbackCandidates shall be notified of the outcome of each stage of the selection process at the earliest possible date.

If, following the interview, a candidate is placed on a panel they shall be informed of their position on the panel. Details of marks attained in the interview process will be provided upon receipt of written request.

4. Deeming of candidature to be withdrawnCandidates who do not attend for interview or other test when and where required by Westmeath County Council, or who do not, when requested, furnish such evidence as required by Westmeath County Council within the specified timeframe with regard to any matter relevant to their candidature, will be deemed to have withdrawn their application from the competition.

5. ReferenceApplicants are required to advise the names of two responsible persons to whom they are well known but not related.

In advance of any offer of employment, Westmeath County Council reserves the right to seek both written and verbal references from current and previous employers, educational institutions or any other organisations with which the candidate has been associated. Westmeath County Council reserves the right to determine the merit, appropriateness and relevance of such references and referees. Information sought from referees shall be structured around the requirements of the job and the job description, person specification and/or competency profile provided.

6. Verification of Education QualificationsPrior to appointment the candidate will be required to present within a specified timeframe, the original parchment of their certificate, diploma and/or degree, and any other supporting documentation required by the Council*, to the Human Resources Department in order to verify their qualifications.*Non Irish Qualifications must be accompanied by a determination from Quality and Qualifications Ireland (QQI) to establish their comparability against the Irish National Framework of Qualifications, overseas qualifications must also be accompanied by a translation document.

7. Pre Employment MedicalPrior to appointment the candidate will be required to complete a Health Declaration and to undergo a medical examination by a qualified occupational health practitioner nominated by the Council.

8. Garda ClearanceGarda Vetting may be sought in accordance with the National Vetting Bureau (Children and Vulnerable Persons) Act 2012 to 2016 and the applicant will be required to fully co-operate with this process.

9. CanvassingAny attempt by a candidate, or by any person(s) acting at the candidate’s instigation, directly or indirectly, by means of written communication or otherwise influence in the candidate’s favour, any member or employee of the Council or person nominated by the County Council to interview or examine applicants, will automatically disqualify the candidate for the position being held.

10. Confidentiality

Westmeath County Council, in its recruitment and selection procedures, has appropriate measures in place to protect the confidentiality of all applicants. All enquiries, applications and other aspects that form part of the recruitment formalities are treated as confidential and are not disclosed to anyone, outside of those directly involved in the recruitment process – subject to the provisions of the Freedom of Information Acts, 1977 – 2014.

Records created, maintained and stored by Westmeath County Council as part of the recruitment and selection process are subject to a range of legislation, including Freedom of Information and Data Protection. Westmeath County Council shall comply with the National Records Retention Policy (2001) and any other relevant records retention policies.

Aras an Chontae, Mullingar, County WestmeathTel: (044) 93 32000

Web: www.westmeathcoco.ie e-mail: [email protected]

Suitably qualified applicants are invited to apply for the following panel(s):

A. Confined Competition (Common Recruitment Pool)B. Open Competition

Panel A (Common Recruitment Pool) will comprise of successful applicants from within the Pool only, i.e candidates serving in a local authority, health board, vocational education committee in the State, institute of technology, the General Medical Services (Payments) Board, St. James's Hospital Board, Beaumont Hospital Board, An Bord Altranais, the Local Government Computer Services Board, the Border, Midland and Western Regional Assembly or the Southern and Eastern Regional Assembly and have satisfactory experience at a level not lower than that of Assistant Staff Officer;

Panel B (Open Recruitment) will comprise of all successful applicants in order of merit and may include internal and external applicants.

Please note;Eligible Common Recruitment Pool applicants may apply for placement on both panels.

Are you a member of the Common Recruitment Pool? Yes No

Are you applying for Panel A? (Common Recruitment Pool) Yes No

Are you applying for Panel B? (Open Recruitment) Yes No

Please ensure that you have selected correctly.

WESTMEATH COUNTY COUNCIL

APPLICATION FOR THE POST OF: STAFF OFFICER Closing Date for receipt of applications: 4.00pm, 3rd May 2019

SECTION A – PERSONAL DETAILS

Surname: BLOCK CAPITALS Forename (s): BLOCK CAPITALS

Address for correspondence purposes:BLOCK CAPITALS

Contact Details:

Home Telephone:Work Telephone:Mobile Tel Number:

Eircode: E-mail Address:

SECTION B – EDUCATION, QUALIFICATIONS and TRAINING

GENERAL EDUCATION

Dates Name of Secondary School (s):

Examinations Taken Subjects Results

From To

ACADEMIC, PROFESSIONAL OR TECHNICAL QUALIFICATIONS:

Dates

CollegeTitle of

Qualification Attained:

Grade

Level in the National

Framework of

Qualifications

From To

Awarding Body:

Date Awarded:

Final Year Examination Subjects:

Dates

CollegeTitle of

Qualification Attained:

Grade

Level in the National

Framework of

Qualifications

From To

Awarding Body:

Date Awarded:

Final Year Examination Subjects:

Dates

CollegeTitle of

Qualification Attained:

Grade

Level in the National

Framework of

Qualifications

From To

Awarding Body:

Date Awarded:

Final Year Examination Subjects:

TRAINING COURSES UNDERTAKEN:

MEMBERSHIP OF PROFESSIONAL INSTITUTIONS:

SECTION C – EMPLOYMENT RECORDPlease give below, in date order (starting with your current employer) full details of all employment between the date of leaving school or college and the present dates. Please do not leave any period between these dates unaccounted for. If necessary, continue on a separate sheet, setting out the information in the same manner as below.

Employer:Address:Nature of Business:

Position Held: Grade (if applicable):

Temporary or Permanent:

Part time or Full Time:

Dates:From To Duration in

months:

Description of main duties and responsibilities

Reason for leaving:

Employer:Address:Nature of Business:

Position Held: Grade (if applicable):

Temporary or Permanent:

Part time or Full Time:

Dates:From To Duration in

months:

Description of main duties and responsibilities

Reason for leaving:

Employer:Address:Nature of Business:

Position Held: Grade (if applicable):

Temporary or Permanent:

Part time or Full Time:

Dates:From To Duration in

months:

Description of main duties and responsibilities

Reason for leaving:

Employer:Address:Nature of Business:

Position Held: Grade (if applicable):

Temporary or Permanent:

Part time or Full Time:

Dates:From To Duration in

months:

Description of main duties and responsibilities

Reason for leaving:

Employer:Address:Nature of Business:

Position Held: Grade (if applicable):

Temporary or Permanent:

Part time or Full Time:

Dates:From To Duration in

months:

Description of main duties and responsibilities

Reason for leaving:

SECTION D – SUPPLEMENTARY INFORMATION

i. Please provide a brief example from your work experience where you have been charged with planning work including the allocation of staff and resources and how you overcame resistance to ensure its success.

Please limit your answers to 200 words. You may be short-listed on the information you supply.

ii. Please provide a brief example from your work experience where you implemented high quality service and customer care standards.

Please limit your answers to 200 words. You may be short-listed on the information you supply.

iii. Please provide a brief example from your work experience where you had to manage conflict within a team and how you resolved this.

Please limit your answers to 200 words. You may be short-listed on the information you supply.

ACHEIVEMENTS/SUPPORTING INFORMATION:Please outline briefly any particular achievments or supporting information you consider relevant to your application (no greater than 200 words):

What aspects of your career to date do you see as being most relevant to the position applied for?

Are you in receipt of Superannuation Allowance in respect of an office of employment under a local authority or a harbour authority? If so, give particulars of pension, office/employment, grounds and date upon which it was granted.

Are you now, or have you been within the past twelve months a member of a Local Authority or a Harbour Authority?

Have you ever accepted voluntary redundancy/early retirement from a local authority or any other public service organisation by which you were employed?

Yes No

If yes, please give details:___________________________________________

________________________________________________________________________________________________

Applications from people with disabilities are welcome and information about disability is only requested on the application form in order that appropriate arrangements for an interview can be made if necessary.

Do you consider that you have a disability? Yes No

Are you registered with any organisation for the disabled? YesNo

If you consider that you have a disability please give details of any requirements for interview arrangements e.g. sign language.

REFEREES

Please provide the names of two responsible persons as referees to whom you are well known but NOT related. (If you are currently employed, one of the referees should be a present employer).

REFEREE NO. 1 REFEREE NO. 2

NAME & ADDRESS NAME & ADDRESS

PHONE NO. PHONE NO.

EMAIL EMAIL

Declaration

I hereby declare that I have complied with all the requirements on the attached checklist and all the particulars furnished in connection with this application are true, and that I am aware of the qualifications and particulars for this position. I understand that I may be required to submit documentary evidence in support of any particulars given by me on my Application Form. I understand that any false or misleading information submitted by me will render me liable to automatic disqualification or render me liable to dismissal, if employed. I hereby authorise Westmeath County Council to seek any additional information they may require in connection with my application for the post.

Failure to sign application will render it invalid. Where an application is submitted by e-mail, candidates shortlisted for interview will be requested to sign a Declaration Form.

Signature of Applicant: ________________________________________

Date: ____________________________