CONFIDENTIAL

Application Form for the Post of KS1 / EYFS Teacher (Full-time)

Personal Information
1.Personal details
Title : / Forename(s): / Surname:
Address:
/ Former name(s):
(including maiden name)
Postcode: / Preferred name:
How long have you lived at this address:
If less than 5 years please provide all previous addresses for past 5 years.
Previous address: / Previous address:
Postcode: / Postcode:
Length of time at address: / Length of time at address:
Contact details
Home telephone:Email:
Mobile telephone:
Work telephone:
2.General
Are you currently eligible for employment in the UK?Yes □No □
Do you have Qualified Teacher Status?Yes □No □
DfE Number
National Insurance Number
Do you have a current full UK driving licence?Yes □No □
Please provide full details of membership of any professional bodies
______
3.Education and Academic and Vocational Qualifications
Dates
(months & years) / Award / Qualifications and grade obtained
From / To
Secondary Education (school/college) / A level subjects Grades
Higher Education
PGCE
Other
Professional Development
Long Courses (Attended during the last 3 years)
Name of Course
(and award if gained) / Provider / Ftime/Ptime or Seconded / Dates
(months & years)
From / To
Short Courses (Attended during the last 3 years)
Name of Course / Provider / Ftime/Ptime or Seconded / Dates
(months & years)
From / To
Outside Interests
4.Present teaching post (if applicable)
Present post (title) / Date appointed to school
Date appointed to post
Basic Salary
Please indicate spine point / Additions
Please indicate responsibility points, London Allowance etc
Total:
Name of school and address
Post code
Type of school / Age range: / No on roll: / Single sex / mixed:

Date when you would be available to start if appointed:

5.History of employment in chronological order with an explanation for any period not in employment.
a)Previous teaching posts held
Name of school
(Independent, GM, Maintained) / B
G
Mixed / Age range / Nos on roll
4–11
11–18 / Post title and scale / Dates
(months & years) / Reason for leaving employment
From / To
b)Details of any non-teaching employment
Employer / Position held / Job Description / Dates
(months & years) / Reason for leaving employment
From / To
6.Please confirm if you know any existing employee, volunteer or Governor at the School and if so, please provide full details of how you know them.
7.Referees
Please provide at least two professional referees. One referee should be your current or most recent employer in education. References will not be accepted from relations or people writing solely in the capacity of friends.
Referee 1 /
Referee 2
Name / Name
Address
Post Code / Address
Post Code
Position / Position
Tel No. / Tel No.
Email / Email
8.Medical Information
Do you have a disability which may require us to make adjustments to our usual selection process?
Yes / No
If Yes, please set out details below including any assistance which you may find helpful.
Please note that any offer of employment is conditional upon your mental and physical fitness to perform the requirements of the role.
9.Data Protection
The information that you provide on this form will be used to process your application for employment. The personal information that you provide will be used in a confidential manner to help with our recruitment process.
If you succeed in your application and take up employment with the School, the information will be used in the administration of your employment.
We may check the information provided by you on this form with third parties.
By signing the application form you consent to the processing of sensitive personal data.
Declaration
I am aware that the post for which I am applying is exempt from the Rehabilitation of Offenders Act 1974 and therefore that all convictions, cautions and bind-overs, including those regarded as “spent” must be declared. I have not been disqualified from working with children, am not named on the DfE List 99 or the Protection of Children Act List, am not subject to any sanctions imposed by a regulatory body, and either (please tick as appropriate):
I have no convictions, cautions, bind-overs or sanctions imposed by a regulatory body
OR
I have attached details of any convictions, caution, bind-overs or sanctions imposed by a regulatory body in a sealed envelope marked confidential
I declare that the information I have given in this application form is accurate and true. I understand that providing misleading or false information will disqualify me from appointment or if appointed, may result in my dismissal.
Signature:Date:

Please return your completed application form for the attention of Miss Nicola Edgar, Head.

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