PART B. Name: Position Applied For: Vacancy Reference Number: GHRNI/001/13. Submission Date:

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1 PART B Name: Position Applied For: Vacancy Reference Number: GHRNI/001/13 Submission Date: Please complete all required fields as accurately as possible ensuring no changes are made to the format of this form. Any changes to this document will invalidate your application. This form must be completed in size 10 font. Completed application forms (Parts A,B and the supplementary form) should be ed to quoting the relevant job reference number. Signed copies must then be posted to Group Resourcing (please refer to our Guidance Information section for further information).

2 GUIDANCE INFORMATION FOR APPLICANTS The following notes should be read in full before an application is submitted. APPLICATION FORMS Completed application forms (Parts A& B) should be ED TO QUOTING THE RELEVANT REFERENCE NUMBER IN THE SUBJECT BOX by the applicant or their representing agency. All applicants are required to follow up their ed application by posting or hand delivering a signed copy to Bank Of Ireland, 1 Donegall Square South, Belfast, BT1 5LR, 6 th floor, Group Resourcing, to be received by the time and date specified on the advertisement. The Bank of Ireland (the Bank ) will not accept responsibility for application forms delivered to any other location. It is the responsibility of applicants to ensure that the application form is fully and correctly completed in that it is signed and that all relevant information in support of their application is included. Each member of the Selection Panel dealing with the appointment will only be given a copy of Part A Section 1 of your application form(the education, employment history and eligibility criteria) for the purpose of determining your eligibility for the post.. Part B - the front page containing your personal details and back pages containing details of your referees and equal opportunities monitoring questions will be held by the recruitment team only, along with the supplementary form. Do not, therefore, include covering letters, references, examination certificates or indeed any documents with your application or write your name on each page of your application. If you do they will be returned to you. Please ensure that you provide evidence of your experience in Part A Section 1 of your application form, giving length of experience, examples and dates as required. It is not sufficient to simply list your duties and responsibilities. The Panel will not make assumptions from the title of the applicant s post or the nature of the organisation as to the skills and experience gained. If you do not provide sufficient detail in Part A Section 1 of your application form, including the appropriate dates needed to meet the eligibility criteria, the Selection Panel will reject your application. Key requirements are found on the role description or advertisement for this position. PRE-EMPLOYMENT SCREENING It is the policy of the Bank that all applicants must agree to undergo a pre-employment screening process before the Bank confirms any conditional offer of employment. The nature of this pre-employment screening process is set out below. We will use electronic screening to verify your identity and eligibility to work in the UK and will also undertake electronic searches of information already available in the public domain. This may include checking sanction lists, embargo lists, Companies Office records etc. Financial Reports - All successful applicants will be subject to a Basic Financial Check. This will provide us with information including data from the electoral register to verify Date of birth, where appropriate, publicly available data to reveal any adverse information, including County Court Judgments, Bankruptcies, Voluntary Arrangements etc and will ascertain whether a candidate holds any current or previous directorships or is currently disqualified Equal Opportunities - The Bank is an equal opportunities employer. Our aim is to ensure that all candidates are treated fairly and that no individual is discriminated against on the grounds of gender, colour, race, nationality, marital status, religion or belief, sexual orientation, disability or age. Regulated Posts - For certain posts within the Bank it may be necessary to carry out criminal record checks prior to candidates being appointed. Having a criminal record will not necessarily bar you from working with us. This will depend on the nature of the position applied for and the circumstances and background of your offences. As an organisation using the CRB Disclosure Service or equivalent service to assess applicants suitability for positions of trust, the Bank complies fully with the CRB Code of Practice and undertakes to treat all applicants for positions fairly. Data Protection - By completing this application you consent to the Bank and any other member of the Bank of Ireland Group (or any of its or their agents) processing your personal data (including sensitive personal data) for the purposes of assessing your application for employment with the Bank, the administration of any subsequent employment, the administration and management of the business of the Bank (or any other member of the Bank of Ireland Group) and for the purposes of complying with applicable laws, regulations and procedures. You further consent to the Bank making such data available to persons other than the Bank where the Bank considers this to be in the interests of the Bank or any other member of the Bank of Ireland Group and to the Bank or any other member of the Bank of Ireland Group transferring such data outside the European Union. ADDITIONAL DOCUMENTATION REQUIRED DURING THE RECRUITMENT PROCESS Prior to commencing employment, successful candidates will be required to: Provide original documentation in relation to educational qualifications, proof of address, proof of identity (passport), National Insurance Number, and confirmation of work eligibility (Work Permit etc). Provide additional documentation where applicable depending on the nature of the role, i.e. driving licence or professional body qualification. Candidates will be advised of specific requirements at the beginning of the selection process. Provide referee details, which are satisfactory to the Bank's referencing policy. Complete a satisfactory health declaration All offers of employment are subject to the above elements being satisfied. formal appointment will be made prior to the vetting procedure being completed. Falsification of any documentation used to identify an individual will result in no appointment being made.

3 SECTION 2 - PERSONAL DETAILS The recruitment and selection panel do not have access to information contained in this Section and it will be detached prior to short listing. Full Name including title: Mr/Mrs/Ms/Dr Previous Name/s: NI Number: Date of Birth (For vetting purposes only): Do you require a work permit? If yes, please give details: Have you ever worked for Bank of Ireland Group, either directly or through an agency? Yes If yes please give details Please give details of any special requirements we may need to be aware of in order to facilitate your attendance at an interview. CRIMINAL RECORD *Do you have any unspent criminal convictions? Yes Detail *Have you ever been convicted of any offence (whether spent or not and whether or not in the United Kingdom) or are you currently subject to any criminal proceedings (i) involving fraud, theft, false accounting, offences against the administration of public justice (such as perjury or perverting the course of justice), serious tax offences or other dishonesty or (ii) relating to companies, building societies, industrial and provident societies, credit unions, friendly societies, insurance, banking or other financial services, insolvency, consumer credit or consumer protection, money laundering, market manipulations or insider dealing? Yes Detail *Answering yes to these questions will not automatically preclude your employment by the Bank. This will depend on the nature of the role and the circumstances and background of your convictions. The Bank will treat fairly and reasonably any subject of a Disclosure on the basis of a conviction, or other information revealed. Additional Information Have you ever received any County Court Judgments or Individual Voluntary Arrangements against you? Yes If Yes, please provide any additional notes Have you ever been declared bankrupt? Yes I have current or previous directorships? Yes

4 CONTACT DETAILS Current Address: Current Postcode: Mobile phone number: Address: Landline number: Previous Address/es & postcodes: Covering last 3 years Previous Address 1: Previous Address 4: Dates at the address - Dates at the address - Previous Address 2: Date at this address - Previous Address 3: Date at this address - DECLARATION Please read the information given at the beginning of this form again (including Basic Financial Checks and Criminal Records checks). By signing this form you give your consent and agree that we can use your information in this way. I declare that all the information provided on this form (and on any attachments if applicable) is accurate and true. I understand and agree that: - Any deliberate misrepresentation or omission could result in the withdrawal of any offer of employment (if successful), or in dismissal should employment have commenced. - Any offer of employment made or employment taken is subject to the receipt of two satisfactory references, verification of educational qualifications, proof of identification, work permit (where applicable) and additional documentation as above. - The Bank and any other member of the Bank of Ireland Group (or any of its or their agents) may process my personal data (including sensitive personal data) for the purposes of assessing my application for employment with the Bank, the administration of any subsequent employment, the administration and management of the business of the Bank (or any other member of the Bank of Ireland Group) and for the purposes of complying with applicable laws, regulations and procedures. I further consent to the Bank making such data available to persons other than the Bank where the Bank considers this to be in the interests of the Bank or any other member of the Bank of Ireland Group and to the Bank or any other member of the Bank of Ireland Group transferring such data outside the European Union. By signing and submitting this application form you agree to your personal data being processed in accordance with the above statement. Name: Date: Thank you for taking the time to complete this Employment Application Form. Please ensure that all sections of Parts A, B and the supplementary form have been completed and returned by to quoting the relevant reference number in the subject box. All applicants are required to follow up their ed application by posting a signed copy by the closing date to Bank of Ireland, 1 Donegall Square South, Belfast, BT1 5LR, 2nd floor, Group Resourcing If you have any queries relating to this form or any stage of the recruitment process please contact Group Resourcing on

5 SECTION 3 EMPLOYMENT REFERENCES The recruitment and selection panel do not have access to information contained in this Section and it will be detached prior to short listing. All Bank of Ireland job offers are subject to two satisfactory employment reference checks covering your last two employers. All referees will be contacted by phone once a job offer has been made and accepted. Your references should come from your current and most recent employers, for school leavers, please supply contact details of a lecturer/teacher. If you do not have a previous employer or have worked for one employer for the duration of your employment to date please give details of a professional person that you know i.e. solicitor, lecturer etc. for a character reference. Reference 1 Reference 2 Referee Name: Referee Name: Company: Company: Job Title: Job Title: Company Address: Company Address: Landline Number Landline Number address: address: Employment Dates: Employment Dates: Reason for leaving: Reason for leaving:

6 Section 4 - EQUAL OPPORTUNITIES MONITORING QUESTIONNAIRE The recruitment and selection panel do not have access to information contained in this Section and it will be detached prior to short listing. INFORMATION YOU PROVIDE WILL BE TREATED AS CONFIDENTIAL THIS MONITORING FORM SHOULD BE RETURNED WITH YOUR APPLICATION IN A SEPARATE ENVELOPE The Bank of Ireland is committed to ensuring that applicants and employees from all sections of the community are treated equally and not discriminated against on the grounds of gender, colour, race, nationality, marital status, religion or belief, sexual orientation, disability or age. This form assists us in monitoring who is applying for employment with us, our adherence to equal opportunities best practice and our progress towards identifying any barriers to diversity among our workforce. We ask some questions regarding disability, which may also assist us in determining whether any reasonable adjustments are necessary to facilitate your interview. This form will be separated from your application on receipt, but if you are subsequently employed by the Bank then we may retain it on your personnel file. We would be grateful if you would fill in this form and return it with your application. You are not obliged to answer all the questions but the more information you supply, the more effective our monitoring will be. All information supplied will be treated in the strictest confidence. Thank you for your assistance. Please state which job you have applied for and the date of your application. Job applied for: Date of application: Question 1 to be completed by applicants who are applying for a vacancy based in rthern Ireland only Questions 2-8 to be completed by all applicants 1. Fair Employment Monitoring The Bank of Ireland has a legal duty to ascertain your community background under the Fair Employment and Treatment (NI) Order Regardless of whether we practice our religion, most of us in rthern Ireland are seen as belonging to either the Protestant or Roman Catholic Community. We are therefore asking you to indicate your community by ticking the appropriate box below. I am a member of the Protestant community I am a member of the Roman Catholic community I am not a member of either Protestant or Roman Catholic Community It is an offence under the Fair Employment (NI) Act 1989 to give false information. 2. Date of Birth 3. What is your gender (please tick)? Male Female If you are currently undergoing the process of gender reassignment, please tick your future gender.

7 4. How would you describe your nationality and/or ethnicity (please tick)? A B C D E White: Black or Black British Chinese or other ethnic group: Mixed race: Asian or Asian British: British - English, Scottish or Welsh Caribbean Chinese White and Black Caribbean White and group Black African Irish African Any other ethnic Any other white background Any other black background White and Asian Any other mixed background Indian Pakistani Bangladeshi Any other Asian background 5. How would you describe your sexual orientation (please tick)? Heterosexual Bisexual Lesbian Gay Other Prefer not to say 6. How would you describe your religion? My religion is I am not religious Prefer not to say 7. Do you consider yourself to have a disability under the DDA (please tick)? The Disability Discrimination Act 1995 (DDA) defines a disability as a "physical or mental impairment, which has a substantial and long-term adverse effect on a person's ability to carry out normal day-to-day activities". An effect is long-term if it has lasted, or is likely to last, over 12 months. Yes Don't know Used to have a disability but have now recovered Prefer not to say 8. If you answered "Yes" to question 7, please give brief details of your condition and please indicate whether you may require any adjustments to enable you to attend and participate in an interview or to carry out any selection tests. Disabled applicants are invited to contact the personnel office in confidence at any point during the recruitment process to discuss steps that could be taken to facilitate attendance and participation at an interview or in order to overcome any operational difficulties presented by the job.

8 Brief details of condition (including whether mental or physical): Adjustments required for interview (including, for example, induction loop/radio aid/speech to text reporter/bsl interpreter/other): Adjustments required for job: Please give details of any other special requirements we may need to be aware of in order to facilitate your attendance at an interview. For the purposes of compliance with the Data Protection Act 1998, I hereby confirm that by completing this form I give my consent to the Bank of Ireland processing the data supplied above in connection with monitoring compliance with its equal opportunities obligations and policy. I also agree to the storage of this information on manual and computerised files. te: This questionnaire should be returned with your signed application form but should be placed in a separate sealed envelope.

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