PROBATION BOARD FOR NORTHERN IRELAND
NAME:
APPLICATION
FOR THE POST OF
Senior Psychologist (Chartered/Registered Psychologist)
Job Reference CRP/ /15
The information provided by you plays an important
part in our selection process.
Information in this form concerning experience and
qualifications may be shared with line management
and the Learning and Development Unit.
Please complete all relevant sections of this form.
We cannot accept CV material in place of any section
of this form.
N.B. If completing application electronically
font size must be no smaller than size 12
otherwise it may not be considered.
N.B. Application form must be returned with Equal Opportunities Monitoring form, completed Convictions Declaration form and completed DDA form.
All forms must be returned or the application will not be considered.
Forms / Office Use OnlyForms Completed & Received
Yes / No
EOM
Convictions
DDA 1
1. Enclosed with this application form should be the following:
- Equal Opportunities Monitoring Form
- Convictions Declaration
- Disability Discrimination Act DDA1 Form
- Information for Applicants
N.B. Information about PBNI may be accessed via our website
Of the above documents you must complete and return the following with your application form.
Please X as appropriate
Forms / Applicant Use
Forms completed & returned
Yes / No
Equal Opportunities Form
Convictions Declaration
Disability Discrimination Act (DDA1)
Please complete this application form in black ink or typescript, no smaller than font size 12 and return it to the Human Resources Department, Probation Board for Northern Ireland, 80-90 North Street, Belfast, BT1 1LD or email to to arrive not later than 4:00pm on Wednesday 19 August 2015.
If returning your application form by post, please ensure you have the correct postage to avoid delay (if in doubt check with the Post Office). PBNI will not accept applications if asked to pay shortfall in postage.
2. Personal DetailsSURNAME: MR/MRS/MS/MISS / FORENAME(S) / NAME KNOWN BY
Home Address: / Address for Communications (if different)
Postcode: / Postcode:
Telephone Numbers: / Home:
Personal Mobile:
Work:
Work Mobile:
Email Address:
Nationality – are you a citizen of a member country of the European Union?
Please X as appropriate
YES / NO
If NO, please specify your nationality:
3a. Details of Current Employment (if applicable)
Name of Employer:
Address of Employer:
Postcode:
Post:
Date Started:
Salary:
Details of Current Employment: (Please use only the space provided below using font size 12 – additional sheets will not be accepted)
3b. Record of Previous Employment
Show in date order (most recent first) and indicate reason for leaving – if you have worked in a number of posts for one employer please indicate job title and dates concerned. Please note your current and previous employer(s) may be contacted to confirm dates of employment as part of the application process.
From: / To: / Position Held:Employer Name and Full Address:
Reason for Leaving:
From: / To: / Position Held:
Employer Name and Full Address:
Reason for Leaving:
From: / To: / Position Held:
Employer Name and Full Address:
Reason for Leaving:
From: / To: / Position Held:
Employer Name and Full Address:
Reason for Leaving:
From: / To: / Position Held:
Employer Name and Full Address:
Reason for Leaving:
From: / To: / Position Held:
Employer Name and Full Address:
Reason for Leaving:
4(a)Completion of Application Form – Important Information
Please refer to the Information for Applicants document which contains information on completing the application form and selection process which you should read before completing and submitting your application form.
4(b)General Shortlisting Guidance – Important Information
The Board has established certain requirements for appointment and in sections 5 - 6 you are asked to provide information in relation to these requirements.
The information you provide in section 5 will be used for sifting and section 6 will be used for shortlisting and it is in your interest to make good use of this opportunity to provide information (even if you have provided similar details in earlier sections of the form).
Applications meeting the essential criteria at siftingmay then be prioritised at shortlisting according to the responses given in section 6 in respect of the desirable criteria.
Each response to a criterion in section 6 on the application form will be rated and categorised with A, B or C rating.
A rating –
- Strong Evidence.
- The answer is clear and directly answers the questions asked.
- Acceptable evidence.
- The answer gives an indication that evidence is present, but is a little vague.
- Poor evidence/lack of evidence.
- The answer does not relate to the question.
*(Please use only the space provided using font size 12 as additional sheets will not be accepted)
5. Essential Criteria
Please use only the space provided for each criterion using font size 12. Additional sheets will not be accepted.
Applicants must by the closing date:
1) Have achieved or be due to attain,no later than 30 September 2015,a post graduate qualification in Forensic or Clinical Psychology as recognised by the British Psychological Society (BPS)
Name of Institute
Address of Institute
Title of Qualification
Date Qualified / (DD/MM/YYY)
2) Be registered with the Health & Care Professions Council (HCPC)
I confirm that I am registered with the Health & Care Professions Council (HCPC).
HCPC Registration number / YES NO
NB In respect of criteria 1 and 2 candidates must be able to provide evidence of qualification and registration upon request.
3)Have a current driving licence and use of a car for official business or access to a form of transport that will permit them to meet the travel arrangements of the job in full.
(a)I have a full valid driving licenceYES NO
(b)I have use of a carYES NO
(c)If NO to (a) and/or (b) above are you seeking reasonable adjustment in respect of disability? This will be discussed with you at appointment stage.
YES NO
*Must be able to produce full valid driving licence, car insurance & vehicle registration document upon request.
4)Be able to demonstrate how they have worked effectively within a team
5)Be able to demonstrate good planning and organising ability including the ability to work effectively to deadlines.
6)Be able to demonstrate effective communication skills.
6. Desirable Criteria.
Please evidence how you meet the criteria 1-3 below:
1) Experience of supervising and managing other psychologists.
2) Experience of development and oversight of offending behaviour programmes and interventions.
3) Experience of working within a forensic setting, to include specialist psychological assessment and report writing to inform risk management of complex cases.
7.Reference Details
Please give details of two people who may be contacted for reference purposes one of whom should be your current (or most recent) employer (please indicate whichever applies) or if you are completing or have very recently completed professional training you may provide an academic referee. You must include one person who has known you for at least three years. N.B. References will be sought forany candidate being conditionally offered a post.
Name:
Address:
Town/City:
Postcode:
Email Address:
Status:
Period of time known to me: / From: / To:
Name:
Address:
Town/City:
Postcode:
Email Address:
Status:
Period of time known to me: / From: / To:
8.Security Vetting Checks
Appointment is subject to receipt of a satisfactory Access NI Enhanced disclosure certificate with checks against the vetting and barred lists for children and adults.
It will be decided whether any criminal record is materially relevant to the particular post.
A copy of The Access NI Code of Practice and Explanatory Guide will be made available upon request to PBNI’S HR team–contact 02890262441 or email also available on the website
9.Signature
The particulars in this application are complete and accurate to the best of my knowledge and belief.
SIGNATURE:
BLOCK LETTERS
DATE:
A candidate found to have knowingly given false information, or to have wilfully suppressed any material fact will be liable to disqualification, or if appointed – to dismissal.
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PROBATION BOARD FOR NORTHERN IRELAND
Equality Monitoring - Applicants
(1)It is the policy of the Probation Board for Northern Ireland that all eligible persons shall have equal opportunity for employment and advancement in the Probation Board on the base of merit. To enable the Board to monitor, check and demonstrate the fairness of our procedures you are asked to answer the questions set out below.
(2)The PBNI is required under the Fair Employment and Treatment Order 1998 to monitor your Community Background and Gender, we also in seeking to discharge our statutory responsibilities under section 75 of the Northern Ireland Act 1998 need to monitor ethnicity, age, sexual orientation, disability, marital status, political opinion and whether or not you have any dependant responsibilities.
(3)Information provided for purposes of monitoring will not be available to those considering applications for employment and will play no part in deciding whether an individual is offered a job or not.
(4)Please note in respect of Community Background that if you complete it by ticking ‘neither community’, the Equality Commission guidance encourages us to use a residuary method to attempt to place you in either the Protestant or Roman Catholic community. This means we can make such a determination on the basis of personal information on your application form.
(5)Only members of staff from PBNI’s Human Resource Department (HR) will have access to information for processing purposes. We will protect this information and use it to help improve our services and to monitor fair participation. Information provided by all applicants will be collated centrally in the HR Department and statistical information for each of the groups in this questionnaire will be produced for analysis by the organisation for legislative and service improvement purposes.
(6)Any queries in relation to equality monitoring should be addressed to the Equality Manager, Probation Board for NI, 80-90 North Street, Belfast, BT1 1LD.
COMMUNITY BACKGROUND
You are requested to indicate below your community background to which you would be perceived to belong. It is an offence to knowingly give false information to anyone seeking this information in order to make a monitoring return. You are also requested to provide schooling information for residuary monitoring purposes if required.
I am a member of the Protestant community
I am a member of the Roman Catholic community
Other (please specify)
Did you attend a primary, preparatory or secondary school in Northern Ireland? / Yes / No
If yes, please list the names and full addresses of all the schools in order of attendance
Name of School / Type of School (Primary/Secondary) / Full Postal Address
Date of Birth
DD/MM/YYYY
Domestic Status
SingleMarriedWidowed/Surviving Partner
SeparatedDivorced/DissolvedCivil Partner
Co-Habitee
Gender
Male / Female
Sexual Orientation
Under the Employment Equality (Sexual Orientation) Regulations (NI) 2003 it is unlawful for employers to discriminate against a person on the grounds of sexual orientation. In order to monitor potential employees, you are requested to complete the section below. Are you?
Heterosexual / Bi-sexual / Gay/Lesbian
Political Opinion
Unionist / Nationalist / Other / None / Prefer not to say
Dependants
Do you have personal responsibility for the care of:
A Child / A Person with a Disability / An Elderly Person / None
Ethnic Origin
White / Bangladeshi / Black other
Chinese / Irish Traveller / Mixed Ethnic Group
Indian / Black African / Other
Pakistani / Black Caribbean / (Please specify):
DISABILITY
Under the Disability Discrimination Act 1995 a person is considered to have a disability if he/she has a physical or mental impairment which has a substantial and long-term adverse effect on his/her ability to carry out normal day-to-day activities.
Do you consider yourself to have a disability? / Yes / No
Does your disability result from one or more of the impairments or conditions listed below? Please indicate which:
Physical, such as using your arms or mobility issues which means using a wheel chair or crutches / Sensory impairment such as being blind/ having a serious visual impairment or being deaf/ having a serious hearing impairment / Mental health condition such as depression or schizophrenia
Learning disability/ difficulty, (such as Down’s syndrome or dyslexia) or cognitive impairment (such as autistic spectrum disorder) / Long standing illness or health condition such as cancer, HIV, diabetes, chronic heart disease, or epilepsy / Other (please specify)
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Official-Sensitive-Personal when completed
CRP / 15PROBATION BOARD FOR NORTHERN IRELAND
DECLARATION OF CONVICTIONS
Before you can be regarded as qualified for appointment you are required to satisfy the Board about your character. Will you please therefore read the notes at the foot of the page and answer the following questions. In all cases you should sign and date the form where indicated. Please note the Rehabilitation of Offenders Order does not apply in this instance therefore you should note all convictions below – none are deemed to be spent.
1Have you at any time been convicted or found guilty of an offence by any court in the United Kingdom or abroad, or by any court martial (excluding parking offences but including all motoring offences even where a spot fine/penalty points have been administered by the police)? / Yes / No
2.Are you currently or have you ever been on probation or on a conditional discharge, or have you been ‘bound over’ after being charged with any offence? / Yes / No
3.Has any charge in respect of any offence been brought against you and not yet disposed of? / Yes / No
4.Have you ever received a formal caution? / Yes / No
5.Are you?
-Insolvent / Yes / No
-A person in respect of whose property a Receiving Order is in effect? / Yes / No
-An undischarged bankrupt? / Yes / No
If the answer to any of these questions is ‘YES’ please give full details below. In the case of questions 1, 2 and 3 these should include the date and place of the court hearing, the nature of the offence and the sentence or order of the court, and if applicable, the name and address of the Probation Officer; you should also say whether we may approach the court concerned to obtain confirmation of the information you have given. If you answer ‘YES’ to question 4 please provide date of issue and details of caution. In the case of question 5, these details should include, if you have been adjudicated bankrupt, the date of the proceedings and the place at which they were held.
Answering ‘YES’ to any of these questions does not necessarily bar you from appointment. Every case is considered on its merits.
NAME:(BLOCK LETTERS)
SIGNED:
DATED:
DETAILS OF CONVICTIONS
NAME:
(BLOCK LETTERS)
SIGNED:
*NOTES:
1.Anyone who wilfully suppresses any information will incur the risk of losing the appointment.
2.Notification should be sent immediately to the address to which the applicationwas returned if any charge is brought against you after you complete and return this formand before you take up appointment offered as a result of this candidature.
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CRP / 15PROBATION BOARD FOR NORTHERN IRELAND
DISABILITY DISCRIMINATION ACT 2005
(As modified by Schedule 8 thereof for application in NI)
The Disability Discrimination Act 2005 builds on and extends disability discrimination legislation, principally the Disability Discrimination Act 1995. This is an important legislative provision in support of the rights of people with a disability.
The Act makes it unlawful to discriminate against disabled people and requires employers to make what are referred to as “reasonable adjustments” to prevent disadvantage to a disabled person. Such adjustments may where practical range from modification to premises through to changes in working arrangements or the provision of special equipment.
We are asking for information to ensure that we have the best possible understanding of individual situations where there is a disability which is or may be relevant to the recruitment/selection process or the demands of the job applied for and addressing matters of reasonable adjustment to prevent disadvantage.
The relevant Code of Practice defines disability as follows:
“A person has a disability if he/she has a physical or mental impairment which
has a substantial and long-term adverse effect on his/her ability to carry out
normal day-to-day activities”.
Detailed definitions are complex but long-term refers to 12 months or more although conditions which are recurring rather than continuous can be included as are those which are likely to last 12 months or more. People who have had a disability are protected from discrimination even if they have since recovered.
The DDA 2005 extends coverage of the DDA 1995 in that people with HIV, cancer and multiple sclerosis (MS) will be deemed to be covered by the DDA effectively from the point of diagnosis, rather than from the point when the condition has some adverse effect on their ability to carry out normal day-to-day activities.
It also removes the requirement that a mental illness must be ‘clinically well recognised’ before it can count as an impairment for the purposes of the DDA.
The legislation places no obligation on disabled people to provide information but we cannot take account of or offer help or support for things which are unknown to us. If you have no information to give or do not wish to give information please complete the NO option. Please sign and return the form.
The information you provide will not be available to short listing or interview panels. If you are successful in the selection process and the panel recommend your appointment, someone from the Human Resources Department will contact you to discuss any relevant matters connected to your disability and questions of reasonable adjustment.
If any particular arrangements are required for any part of the selection /interview process panel members will be given only such information as they need to facilitate the arrangements.
If you need more information on the law relating to disability to help you decide how to complete this form, or have any questions about how the information you will provide will be used, please contact us and this will be provided. Where necessary the closing date will be extended to allow for this.