APPLICATION FORM – Teaching Staff Application for the post of 1 ...

APPLICATION FORM – Teaching StaffApplication for the post of _____________________________________1 Personal DetailsSurname:Title: Mr/Mrs/Miss/Ms/Dr/Home address:First Names:(Underline preferred name)Former Name(s):Address for correspondence (if different)Post codeTel no (day):Tel no (evening):Date of Birth:Post codeMobile number:Email address:National Insurance Number:2 Education and Qualifications post 142.1 GCSEs or equivalentSecondary schoolDatesFromToQualification/sGrade1 of 10

2.2 A levels or equivalentSecondary schoolDatesFromToQualification/sGrade2.3 Degree / diploma or equivalentInstitutionDatesFromToQualification/sGrade2.4 Other qualificationsInstitutionDatesFromToQualification/sGrade2 of 10

3 Employment History3.1 Present or most recent employerPost TitleFT/PTName of school/collegeType ofinstitutionAgerangetaughtFromDatesToBrief description of responsibilitiesExtra Curricular ContributionPastoral Care InvolvementReasons for LeavingDate by which notice has to be given Current salary £3 of 10

3.2 Previous Teaching AppointmentsIn chronological order please, starting with the most recent. Include unpaid activities such as parenting, voluntary work and teachingpractice if you are a student. Continue on a separate sheet if necessary.Post TitleFT/PTName of school/collegeType ofinstitutionAgerangetaughtFromDatesToReasons for leaving4 of 10

3.3 Other Employment HistoryOther employment from the age of 18 years (if any), including explanations for periods not in employment, education ortraining. Continue on a separate sheet if necessary.Post TitleFT/PTName and type oforganisationResponsibilities, experience andreasons for leavingFromDatesTo4 Relevant courses attended within the last three yearsCourse titleDate andDuration Organising body Subject or type of course5 of 10

5 Personal StatementPlease write a personal statement below no longer than one side of A4 in support of your application,including why you believe your qualifications and experience equip you for this post. You may includecommunity responsibility or involvement, family circumstances, professional skills, hobbies and pastimes etc6 of 10

6 Additional InformationDo you have Qualified Teacher Status? If so, please provide your DfES reference number.Do you have any health issues which would prevent you carrying out the duties of the post?Are you legally entitled to work in the UK? YES/NOAny other factors which you would like us to take into account when considering your application, includingany special needs.7 of 10

8 Rehabilitation of Offenders Act 1974The Rehabilitation of Offenders Act (Exemption) Order 1975The provision under the above legislation relating to non-disclosure of spent convictions does not apply to anyemployment as a teacher in a school or any other employment which is carried out wholly or partially withinthe precincts of a school, being employment of such a kind as to enable the holder to have access to personsunder the age of 18 in attendance at the school in the course of his or her normal duties.You must, therefore, give information concerning any previous convictions or cautions, whether or not theyare ‘spent’ within the meaning of the Act.Failure to disclose any conviction or caution could lead to an application being rejected or may later lead tothe dismissal of a successful applicant. (An Enhanced Criminal Records Bureau check will be carried out beforeappointment.)Give details of any criminal convictions below. If you have no convictions, please write ‘NONE’. You are advisedthat information regarding convictions will not necessarily disqualify you from consideration. All informationwill be treated in strict confidence.Please note that only motoring fixed penalties are not convictions under the Law and, therefore, do not need tobe declared.Offence Date OutcomeSignedDate9 of 10

9 DeclarationProviding false information is an offence and could result in an application being rejected, or summary dismissal ifthe applicant has been selected, and possible referral to the police.I declare that the information I have given is correct and that I agree to obtain an Enhanced Level CRB Disclosureas and when necessary.I declare that I am not on List 99, not disqualified from work with children, or subject to sanctions imposed by aregulatory body, e.g. the General Teaching Council (GTC).Signed:Date:Please print name:FOR OFFICE USEPlease complete this application form and send it, with a handwritten letter of application nolonger than one side of A4 to the Headmistress, Mrs S Clark MA by the closing date.15 November 201010 of 10