Application Form: IT Technical Support, Grade VI, Healthcare

This document is a comprehensive application form for an IT Technical Support position, specifically Grade VI within the Healthcare Pricing Office/Activity-Based Funding. The application meticulously details the candidate's personal information, including contact details, and addresses eligibility criteria by providing extensive experience in IT software development, web-based database applications using ASP.NET and SQL server, and software development using JavaScript, AJAX, CSS, and HTML. The candidate also showcases experience in stakeholder management for defining software requirements. The application form includes detailed career history, supplementary questions addressing planning and resource management, problem-solving and decision-making, and team working skills. The applicant also acknowledges and agrees to the general declaration regarding obligations in the recruitment process. This application is a strong example of how to present relevant qualifications and experience in response to a specific job posting.

Candidate ID Number NRS04510–
All sections to be completed in full
APPLICATION FORM
Grade VI IT Technical Support
Healthcare Pricing Office/Activity-Based Funding
NRS04510
Please carefully note the following instructions:
 Please ensure you fully read and understand the ‘Additional Campaign Information for Candidates –
Grade VI - IT Technical Support, Healthcare Pricing Office/Activity-Based Funding ’ document specific
to this campaign that is available on http://www.hse.ie/eng/staff/jobs/job_search/.
 Please ensure you read in full, the instructions for the completion of this application form and complete
all areas, including the supplementary questions section, in full. Failure to complete all areas of the
application form may result in you not being brought forward to the interview stage of the selection
process.
 Candidates should note that there can be a time delay in receiving email applications. We recommend
that applicants wishing to return an application by email should allow a minimum of 1 hour for their
application to reach [e-mail], by the closing time of 12.00 noon on Thursday 26th
January 2017. Applications will not be accepted after this date and time, no exceptions will be made.
 It is preferable that Application Forms are typed.
 Applications must be submitted as a Microsoft Word or PDF document format only. Applications stored
on personal online storage sites, e.g. Onedrive, Cloud, Dropbox, Google Drive etc will not be accepted,
applications submitted in other file formats e.g. Google Docs will not be accepted. Please pay particular
attention to ensure that your application is attached as an attachment (not a link to an on line storage
site e.g. Google Drive) when emailing your application.
 In relation to details of employment, if the space provided is insufficient, please attach additional pages
ensuring to use the same format.
 Please read the Job Specification which provides useful information about the requirements of this post.
 Should you be invited for interview, you may take a 'hard' copy (or 'paper' copy) of your application form
with you. Mobile devices are not permitted for use during your interview.
 The Health Service Executive will run this campaign in compliance with the Code of Practice prepared
by the Commission for Public Service Appointments (CPSA). The Codes of Practice are available on
the CPSA website www.cpsa.ie. Further information is also available in the Additional Campaign
Information document available on http://www.hse.ie/eng/staff/jobs/job_search/.
 The Health Service Executive is an Equal Opportunities Employer.
 The Health Service Executive recognises its responsibilities under the Data Protection Acts 2003 &
1988 and the Freedom of Information Act 2014.
Please return completed application form to:
E-mail: [e-mail]
Post: Grainne Colreavy, HBS National Recruitment Service, HSE, Aras Slainte Chluainin,
Manorhamilton, Co. Leitrim,
Closing date for applications: Thursday 26th January 2017 at 12 noon
It is anticipated that interviews will be held: February 2017
NRS04510 Grade VI – IT Technical Support, Healthcare Pricing Office/Activity-Based Funding
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Candidate ID Number NRS04510–
Applicant Details:
Position Applied for: IT Technical Support – Grade VI
Healthcare Pricing Office/Activity-Based Funding
Grade Code 0574
Position Reference No.: NRS04510
Candidate Reference No (office use only) NRS04510 -
Personal Details:
First Name :
Last Name:
Postal address for correspondence:
MOBILE TELEPHONE (mandatory):
Contact Tel No. 2:
E-mail Address (mandatory):
(You may provide more than one)
PPS Number (mandatory)
Drivers Licence (please state type & category):
European Economic Area
Are you an EEA (European Economic Area) National? Yes / No
Please see Appendix 2 of Additional Campaign Information document for definition of an EEA National.
NB If you are a non EEA citizen you must provide the requested documentation to support your
application. For further information you must read “Appendix 2” in the “Additional Campaign Information”
document.
Where did you see this position advertised?
To help us gauge the efficiency of our advertising strategy for this campaign, the HSE would appreciate it if
you indicated in the table below where you saw this campaign advertised.
HSE website – www.hse.ie
Word of mouth - my manager / colleague
Notification from HSE Talent Pool
Other, please say which
++ More than one indication is allowed.
NRS04510 Grade VI – IT Technical Support, Healthcare Pricing Office/Activity-Based Funding
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Candidate ID Number NRS04510–
1. Superannuation Schemes
Are you currently in receipt of a Voluntary Early Retirement or Ill Health Early Retirement Pension from any
of the Public Health Superannuation Schemes listed at 1-5 below, or any other Public Sector Pension
Scheme?
Are you currently in receipt of a pension from any of the following superannuation schemes? (This
means have you retired?)
YES NO
1. Local Government Superannuation Scheme (LGSS)
2. Health Service Executive Employee Superannuation Scheme
3. Voluntary Hospital’s Superannuation Scheme (VHSS)
4. Nominated Health Agencies Superannuation Scheme (NHASS)
5. Other Public Service Superannuation Scheme
If you have answered ‘yes’ in relation to being in receipt of a pension from any of the above Superannuation
Schemes you are not eligible to apply for this recruitment campaign. Please read Appendix 4 in ‘Additional
Campaign Information’ for further details.
2. Current Contractual Status
 I am currently a HSE employee* Yes No
 I am currently a Tusla employee* Yes No
Please tick the HSE/Tusla Area in which you work
Dublin Mid Leinster South
Dublin North East West
If you answered yes to the above question, please choose the option below which best matches your current
contractual status:
 I have a permanent contract
or
 I have a temporary contract
*HSE / Tusla Employee = you are a direct employee of the HSE or Tusla and not in a post funded or partially funded by
the HSE or Tusla
3. Proficiency in Irish
Candidates will be afforded the added opportunity to demonstrate their ability to perform the duties of the
office through Irish. This assessment will be on a pass/fail basis and will not disturb the marks awarded in
the selection process. Where vacancies arise for which proficiency in Irish is a management requirement,
the HSE will offer such posts in order of merit to candidates who have successfully passed the Irish
assessment. Please indicate if you wish to undertake an Irish assessment exam Yes / No
NRS04510 Grade VI – IT Technical Support, Healthcare Pricing Office/Activity-Based Funding
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Candidate ID Number NRS04510–
ADDITIONAL EDUCATIONAL ACHIEVEMENTS
Please include second level and any (additional) third level educational achievements:
Dates
From / To
Educational
Institution
Conferring
Body
Course of Study Qualification
Achieved
Grades
Achieved
NRS04510 Grade VI – IT Technical Support, Healthcare Pricing Office/Activity-Based Funding
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Candidate ID Number NRS04510–
CAREER OVERVIEW
IMPORTANT: Please ensure all career history is clearly outlined below (e.g. if you took a career
break, spent time out of work, please include this information so there are no gaps in your career
history from when you left full-time education to present date).
From To Title Employer
DETAILED CAREER HISTORY – listing the most recent first:
Job Title:
Grade/ Management Level (if applicable):
Employer(s) & Department Name:
From (00/00): To(00/00/) :
Main Roles & Responsibilities:
Job Title:
Grade/ Level (if applicable):
Employer(s) & Department Name:
From (00/00): To(00/00/) :
Main Roles & Responsibilities:
NRS04510 Grade VI – IT Technical Support, Healthcare Pricing Office/Activity-Based Funding
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Candidate ID Number NRS04510–
Job Title:
Grade/ Level (if applicable):
Employer(s) & Department Name:
From (00/00): To(00/00/) :
Main Roles & Responsibilities:
Job Title:
Grade/ Level (if applicable):
Employer(s) & Department Name:
From (00/00): To(00/00/) :
Main Roles & Responsibilities:
Job Title:
Grade/ Level (if applicable):
Employer(s) & Department Name:
From (00/00): To(00/00/) :
Main Roles & Responsibilities:
NRS04510 Grade VI – IT Technical Support, Healthcare Pricing Office/Activity-Based Funding
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Candidate ID Number NRS04510–
ELIGIBILITY CRITERIA
Please indicate below how your professional experience meets the eligibility criteria for the post of
Grade VI – IT Technical Support, Healthcare Pricing Office/Activity-Based Funding.
This section will be assessed by a board of Senior Managers to consider your experience as it is
relevant to the eligibility criteria.
 Please note that if you omit information in this section pertinent to the eligibility criteria you may
be deemed ineligible and subsequently not called forward to interview.
 Short listing may occur based on the information provided here and in the other areas of this
application form.
 Please complete each section below. As you complete each section we recognise there will be
overlap in the employer and date periods.
1. Please demonstrate significant experience in an IT software development environment which has
included experience developing Web based database applications using ASP NET and SQL server, as
relevant to the role.
Date(s) from – Date(s) to Employer(s) & Department Name
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Candidate ID Number NRS04510–
2. Please demonstrate your significant experience of developing software using Javascript, AJAX, CSS
and HTML, as relevant to the role.
Date(s) from – Date(s) to Employer(s) & Department Name
3. Please demonstrate your experience of working with stakeholders in defining software requirement for
the business needs, as relevant to the role.
Date(s) from – Date(s) to Employer(s) & Department Name
NRS04510 Grade VI – IT Technical Support, Healthcare Pricing Office/Activity-Based Funding
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Candidate ID Number NRS04510–
Supplementary Questions 1 - 3
A guide to completing supplementary questions is available in Appendix 1 of this application form. It is strongly
recommended that you read the guide before completing this section of your application form.
In the spaces below, briefly describe what you consider to be a good example of demonstrating your ability in
each of the skill areas 1-3. A summary definition of each of skill areas is provided for your information. This is a
summary of what we mean by each skill heading. Please provide the information in the format requested at (a),
(b), and (c) on the “Information on completing the Supplementary Questions” Section. Remember anything you
say may be used as part of a shortlisting/ranking exercise and may be discussed in more depth at interview,
should you be called to one.
1. Planning & Managing Resources including Commitment to a Quality Service.
 An effective Grade VI IT Technical Support demonstrates strong planning and organising skills including, structuring
and organising own work load and that of others effectively. S/he demonstrates the ability to use computer
technology effectively for the management and delivery of results. S/he demonstrates the ability to take
responsibility and be accountable for the delivery of agreed objectives. S/he demonstrates a logical and pragmatic
approach to workload, delivering the best possible results with the resources available. S/he demonstrates evidence
of incorporating the needs of the service user into service delivery along with evidence of proactively identifying
areas for improvement and the development of practical solutions for their implementation. S/he demonstrates
evidence of practicing and promoting a strong focus on delivering high quality customer service for internal and
external customers. S/he demonstrates commitment to developing own knowledge and expertise.
In the space below, please give an example of a situation where you best demonstrated your ability in this area.
NRS04510 Grade VI – IT Technical Support, Healthcare Pricing Office/Activity-Based Funding
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Candidate ID Number NRS04510–
2. Evaluating Information, Problem Solving & Decision Making
An effective Grade VI IT Technical Support demonstrates the ability to gather and analyse information from relevant
sources, weighing up a range of critical factors to develop solutions and make decisions as appropriate. S/he
demonstrates ability to make sound decisions with a well-reasoned rationale and to stand by these, along with initiative in
the resolution of complex issues. S/he demonstrates a capacity to develop new proposals and put forward solutions to
address problems.
In the space below, please give an example of a situation where you best demonstrated your ability in this area
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Candidate ID Number NRS04510–
3. Team Working
An effective Grade VI IT Technical Support demonstrates the ability to lead the team by example, coaching and supporting
individuals as required. S/he demonstrates the ability to work with the team to facilitate high performance, developing
clear and realistic objectives. S/he demonstrates the ability to address performance issues as they arise. S/he
demonstrates flexibility and willingness to adapt , positively contributing to the implementation of change.
In the space below, please give an example of a situation where you demonstrated your ability in this area.
NRS04510 Grade VI – IT Technical Support, Healthcare Pricing Office/Activity-Based Funding
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Candidate ID Number NRS04510–
General Declaration
It is important that you read this Declaration carefully and then sign it in the space below.
Part 1: Obligations Placed on Candidates who participate in The Recruitment Process.
The Public Service Management (Recruitment and Appointments) Act 2004 makes very specific provisions in
relation to the responsibilities placed on candidates who participate in recruitment campaigns and these are
detailed in Section 4 of the Code of Practice issued under the Act.
These obligations are as follows:
Any canvassing by or on behalf of candidates shall result in disqualification and exclusion from the
recruitment process. Candidates shall not:
 knowingly or recklessly make a false or a misleading application
 knowingly or recklessly provide false information or documentation
 canvass any person with or without inducements
 impersonate a candidate at any stage of the process
 knowingly or maliciously obstruct or interfere with the recruitment process
 knowingly and without lawful authority take any action that could result in the compromising of any test
material or of any evaluation of it
 interfere with or compromise the process in any way
Any person who contravenes the above provisions, or who assists another person in contravening the above
provisions, shall be guilty of an offence.
It is the policy of the HSE to report any such above contraventions to An Garda Siochana.
In addition, where a person found guilty of an offence was or is a candidate at a recruitment / selection
process, then, in accordance with the Public Service Management (Recruitment and Appointments) Act
2004.
 where he / she has not been appointed to a post, he / shall be disqualified as a candidate; and
 where he / she has been appointed as a result of that process, he / she shall forfeit that appointment
Part 2
Declaration: “I declare that to the best of my knowledge and belief there is nothing in relation to my conduct,
character or personal background of any nature that would adversely affect the position of trust in which I
would be placed by virtue of my appointment to this position. I hereby confirm my irrevocable consent to the
Health Service Executive to the making of such enquiries, as the Health Service Executive deems necessary
in respect of my suitability for the post in respect of which this application is made.
I hereby accept and confirm the entitlement of the Health Service Executive to reject my application or
terminate my employment (in the event of a contract of employment having been entered into) if I have
omitted to furnish the Health Service Executive with any information relevant to my application or to my
continued employment with the Health Service Executive or where I have made any false statement or
misrepresentation relevant to this application or my continuing employment with the Health Service
Executive.
Furthermore, I hereby declare that 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.”
Failure to sign application will render it invalid1.
Signed: __________________________(Name of Applicant) Date: _____________________
1 If you are submitting your application form via email we will accept the application form unsigned but you will be
required to sign the Declaration at interview should you be invited to one.
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