Candidate Reference No (office use only) NRS02914 - 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 did you see this position advertised? 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 2” in the Campaign Information” “Appendix “Additional document. Superannuation Schemes Are you currently in receipt of a pension from any of the following superannuation schemes? (This means have you retired?) YES NO Local Government Superannuation Scheme (LGSS) Health Service Executive Employee Superannuation Scheme Voluntary Hospital’s Superannuation Scheme (VHSS) Nominated Health Agencies Superannuation Scheme (NHASS) If you have answered in relation to any of the above Superannuation Schemes you are not eligible to ‘yes’ apply for this recruitment campaign. Former Health Service and public sector employees must ensure that they adhere to their contractual obligations where they have previously availed of the Incentivised Scheme of Early Retirement (ISER), 2010 Voluntary Early Retirement Scheme (VER) or 2010 Voluntary Redundancy Scheme (VRS). Please read Appendix 4 in Campaign Information’ for further details. ‘Additional
Candidate Reference No (office use only) NRS02914 - 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 did you see this position advertised? 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. Superannuation Schemes Are you currently in receipt of a pension from any of the following superannuation schemes? (This means have you retired?) YES NO Local Government Superannuation Scheme (LGSS) Health Service Executive Employee Superannuation Scheme Voluntary Hospital’s Superannuation Scheme (VHSS) Nominated Health Agencies Superannuation Scheme (NHASS) If you have answered ‘yes’ in relation to any of the above Superannuation Schemes you are not eligible to apply for this recruitment campaign. Former Health Service and public sector employees must ensure that they adhere to their contractual obligations where they have previously availed of the Incentivised Scheme of Early Retirement (ISER), 2010 Voluntary Early Retirement Scheme (VER) or 2010 Voluntary Redundancy Scheme (VRS). Please read Appendix 4 in ‘Additional Campaign Information’ for further details.
nrs02914---application-form.docx