 Please complete in either typescript font size 12, or write clearly using black ink.

Please ensure that you attach your CV.
 Please ensure that you attach your Political and Equality & Diversity Questionnaires.
APPLICANT INFORMATION
Position Applied for:
Surname
Home Address
Home Phone No
Boundary Commission for Northern Ireland
First
Name
Mobile
Title
E-mail Address
National Insurance
Number
CONFLICTS OF INTEREST
Please give details of any personal, business, political or other interests, which your appointment to the Northern Ireland Office could result in, or be perceived as, a conflict of interest. Please also provide information on how you would address the issue should you be successful in your application.

PERSONAL STATEMENT
The following page gives you the opportunity to give details of the qualities, skills and experience you can bring to the position for which you are applying. You should refer to the person specification in the candidate information pack before completing your statement.
Please note that you must restrict your statement to a maximum of one page.

ACCESS OR OTHER REQUIREMENTS
If called for interview, will you require any special assistance? If so, please specify below. Please also indicate if there are any dates in October/November 2015 that you will be unavailable if called for interview.
DECLARATION AND SIGNATURE
In line with the Northern Ireland Office’s principles of openness and transparency some of the application information may be made public on appointment. This may include a brief summary of your career/experience; the length of appointment; whether it is paid or not and, if so, the amount; a list of other appointments held with any related remuneration received; and your response to the political activity question.
I confirm that, to the best of my knowledge, the information I have given is correct and I am willing to commit the necessary time to the Boundary Commission for Northern Ireland.
Signature:
Date:
(Please type your full name if returning electronically)
APPLICATION PROCESS
E-mail your completed application form accompanied by your CV and a copy of your
Address: Competition Co-ordinator,
Northern Ireland Office, Room
Political and Equality & Diversity Questionnaires to: bcni2015
@nio.x.gsi.gov.uk
122, Stormont House Annex,
Stormont House, Belfast, BT4
3SH
If do not receive a confirmation of the safe receipt of your application within 48 hours
(please allow extra time if sent at the weekend)
Tel: 028 90765497 then please call us to check we have received it.
Please return the completed form by email or to the address above to be received no later than
Friday 9 th October 2015 . Late applications will not be accepted.
EQUALITY OF OPPORTUNITY
Appointments will be made on merit and with regard to the equality provisions set out in Section
75 of the Northern Ireland Act 1998. We encourage applications from all sections of the community.

GUARANTEED INTERVIEW SCHEME
We guarantee to interview anyone with a disability whose application meets the minimum criteria for the post. By ‘minimum’ criteria we mean that you must provide us with evidence in your application summary form which demonstrates to the selection panel that you generally meet the level of competence required for any of the qualifications, skills or experience as set out in the candidate’s information pack for the post).
What do we mean by disability?
The Disability Discrimination Act 1995 defines a disabled person as someone who has a physical or mental impairment which has a substantial and adverse long-term effect on his or ability to carry out normal day-to-day activities.
How do I apply?
If you want to apply under the Guaranteed Interview Scheme simply complete the declaration below and send it in with your application.
We will try to provide access, equipment or other practical support to ensure that if you have a disability you can compete on equal terms with non-disabled people.
DECLARATION
I consider myself to have a disability as defined above and I would like to apply under the
Guaranteed Interview Scheme.
I require the following special arrangements to be made for me to be able to attend an interview:
…………………………………………………………………………………………………
…………………………………………………………………………………………………
Name: …………………………………..……… Date: ………………………..….….
Signature*: …………………………………………………………………………….…….
Vacancy Job Title: ………………………………………………………..........................
*There is no need for a signature if you are submitting the form electronically.
Please return the completed form with your application.
ANY FALSE DECLARATION OF DISABILITY TO OBTAIN AN INTERVIEW WILL
SUBSEQUENTLY INVALIDATE ANY OFFER OF A POST