APPLICATION FOR PROGRAMME FACILITATORS
1. General Information:
Name & Address: _________________________________________________________________________
Tel: ______________________
Email: _______________________________________________
2. Previous experience in working with a community organisation
Have you been involved in a voluntary / community organisation before? Yes ___,
No ___,
If you have been involved, please fill in the details:
Name of Organisation:
1.
Type of Involvement:
2.
3.
3. Working with Domestic Abuse
What is your understanding of “Domestic Abuse”? ______________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
_________________________________________________________________________________________
Have you or anyone close to you ever been a victim of domestic abuse?
Yes ( )
No ( )
1
What do you know about MOVE?
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
_________________________________________________________________________________________
Why do you want to work/volunteer with MOVE?
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
What concerns, if any, would you have about being involved? _____________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
4. Work/Volunteer options
What skills and experience do you want to offer MOVE?
_________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
What other experience, skills and/or qualities would you bring to the work of MOVE?
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
Please indicate your relevant third level and/or professional qualifications:
__________________________________________________________________________________________
__________________________________________________________________________________________
2
__________________________________________________________________________________________
__________________________________________________________________________________________
Please give details below of 2 people who have agreed to act as referees for you. One of these should be
your employer. Your referees should not be related to you.
Referee 1
Referee 2
Name:
Address:
Tel. No.
Email address
Relationship: e.g.
Direct Supervisor
Current employer
Other
MOVE has put the following process in place for selecting and supporting its Facilitators.
a)
b)
c)
d)
e)
f)
Completion of Application Form
Interview
Reference checks and Garda clearance
Training
On-going Support
Regular external Supervision
Please sign here: _______________________________
Date: _________________
Please return the completed form and your Curriculum Vitae to:
MOVE Ireland, Unit 2, First Floor, Clare Rd Buisness Centre, Clare Rd, Ennis, Co Clare
Or
Email to: [email protected]
Thank you for your interest.
FOR OFFICE USE ONLY
Application received:
________________________
Interview completed:
____________________
References checked:
________________________
Garda clearance:
____________________
3