Work Experience - UL



This summary qualifications and experience form has been designed to establish your eligibility requirements and quantify your most pertinent relevant experience and achievements to date. Much of the information requested here will also be required to complete the online form. Where you feel that this form does not accurately capture a specific aspect of your experience to date you may provide additional details in the online form as needed.Candidate Name: ____________________________________________________ Application Number: _____________________________Do you hold an Honours Psychology Degree or a recognised Conversion Qualification in Psychology (e.g. HDip in Psychology) from a University or third level institution in Ireland or the UK?YESNOCan you confirm that the above qualification confers eligibility for Graduate Membership of the Psychological Society of Ireland or the Graduate Basis for Chartered (GBC) membership of the British Psychological Society? YESNOImportant Note: If you have any doubts concerning your eligibility for Graduate Membership of The Psychological Society of Ireland you must obtain clarification prior to submitting your application. If you obtained your primary honours degree in psychology or your conversion qualification in psychology outside the Republic of Ireland or Northern Ireland you must provide written evidence of eligibility for Graduate Membership of the Psychological Society of Ireland or the Graduate Basis for Chartered (GBC) membership of the British Psychological Society otherwise your application will not be considered.Indicate either your Psychology Degree or Conversion Qualification grade here only. (Please indicate your relevant qualification grade by entering X in one column below only)Primary Psychology Degree(e.g. BA (Hons) or BSc (Hons) in Psychology)Conversion Qualification (e.g. HDip in Psychology)1st2.12.23rd General Academic Qualifications (note: if more than one award for a given category, add subsequent award under ‘Other’ at bottom of table)Qualification TypeAwarding Institution & Exact Title of ProgrammeAward Category (e.g. pass)Awarded (Yes/No)DATE awarded Transcript included (Y/N)* PhD in PsychologyPhD in Health-related areaResearch Masters in Psychology2 Year Masters in Psychology by courseworkPhD in area other than Psychology/Health1 Year Masters in Psychology by courseworkMasters – interdisciplinary (e.g. ABA or Cognitive Neuroscience)Professional qualification in a relevant area of Social, Healthcare, or teaching fieldMasters in a non-Psychology areaNCEA Diploma in PsychologyNCEA Certificate in field related to PsychologyOther 1Other 2*A transcript is not required for a psychology qualification (Degree or H.Dip in Psychology) from UL, but is required for all other qualificationsRelevant Work Experience (please add additional rows as needed and complete all columns)Note: You must provide all required information below, otherwise your experience will be disregarded for calculation purposes.Job title*Indicate if Paid/UnpaidEmployer Name & AddressName and Full Professional Title of your Primary SupervisorPeriod of EmploymentDuration (in months). For most recent post, calculate duration to closing date of competition.Hours Per WeekAccrued as part of an academic programme?1Official use only1Note: Where a placement/experience was undertaken as part of a course of study, applicants must enter ‘yes’ here. Otherwise, enter ‘no’.* Note: For coding purposes use the following job titles in Section 5 Practitioner Psychologist holding a Post-Graduate Professional Training Qualification recognised by PSI (e.g. Educational or Counselling Psychologist)Assistant Psychologist supervised by Practitioner Psychologist with Post-Graduate Professional Training recognised by PSI. (Must specify - Clinical/Educational/ Counselling/ etc)Research Assistant / Research Associate / Research Fellow supervised by a Clinical PsychologistProfessionally qualified Social Worker, Occupational Therapist, Speech & language Therapist, Physiotherapist Research Assistant / Research Associate / Research Fellow not supervised by Clinical Psychologist(specify exact title and/or professional qualification)Graduate Psychologist under supervision of a Psychologist (not a Clinical, Counselling or Educational Psychologist- specify exact title and/or qualification)ABA Tutor / Behaviour Support Specialist, Senior/Specialist NurseGraduate Psychologist under supervision of a related professional discipline (e.g. Consultant Psychiatrist, Occupational Therapist)Psychology Tutor/LecturerSenior or Specialist NurseRegistered Nurse, Counsellor, Addictions CounsellorPlay therapist, Care Worker, Residential Worker, Support Worker, Other Health or Social Care roles not otherwise specifiedDo you hold a full driving licence and have access to a vehicle (should it be necessary to travel to and from work using a private vehicle)? Full LicenceYESNOVehicleYESNOAdditional academic achievements (note: not all applicants will have additional academic achievements).Peer-reviewed Publications(APA Format Please)References here Other Publications(e.g. HSE Report)References hereConference PresentationsReferences herePrizes, Merits, Scholarships or DistinctionsDescription here for each ................
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