EE175 - Tipperary Energy Agency

Position being applied for*

Name*

First Middle Last

Permanent Address*

Address for Correspondence

(if different from above)

Telephone (Home)*

Telephone (Mobile)*

Email*

Citizen of the European Union?*

Yes
No

Full Driving Licence?*

Yes
No

Where did you hear about this vacancy?*

ACADEMIC RECORD

Post Primary Education*

(Name the School/College and give dates from and to)

School / College	Date From:	Date To:

Third Level Qualifications*

(Name each subject, give the level – Ordinary / Higher, and the result in each case)

Degree Level	Grade	College	Awarding Institution	Date of Entry to Course	Date Conferred

Professional Body Memberships*

(incl. grade and year), fellowships, training courses etc.

OTHER QUALIFICATIONS:*

OTHER TRAINING COURSES UNDERTAKEN:*

Employment Record

Previous Positions / Employment*

(In descending date order) Complete If Applicable

Date From	Date To	Employer	Position Held	Roles and Duties in relevant previous Roles	Reason for leaving

Required Notice Period*

Current Salary*

Have you applied to the Agency for a Job previously?*

What Position(s)?

Please list the positions within TEA that you have applied for before.

Position	Year

For your current role (or last), please outline your key functions, competencies and responsibilities that make you suited to this role:

For any role(s) previous to the above role, please outline your key functions, competencies and responsibilities that make you suited to this role:

ADDITIONAL INFORMATION*

Please provide any additional information you think would be beneficial

SUITABILITY*

Please outline what you feel you can bring to this role at the TEA and how you can assist the agency in meeting its mission.

Documentation: File / Form Upload*

As part of Tipperary Energy Agency’s selection procedures it is necessary to ratify the qualifications stated in this application. Please attach a copy of driving licence and all qualifications as listed in this application form. Please only upload copies documents which are relevant to your application.

Drop files here or

References*

Please list two persons from whom the TEA may request references on your behalf. Your present employer (or immediate past employer, if you are currently unemployed) should be included. One of the referees should be your current or last employer. No referee will be contacted prior to your consent.

Referees Name	Position	Organisation	Address	Telephone

No paper application will be accepted.