Application Form
Please complete in legible ink.
All information given will be treated in confidence.
You must complete all sections. If extra sheets are use, please mark clearly with your name.
JOB TITLE: Classroom Assistant (SEN)Jobs A & B
Closing date for receipt of completed applications:
4pm Wednesday 7th June 2017 / Please tick which job you wish to apply for:
Job A (20 hrs + 5 hours): □
Job B (20 hrs & 5 hours): □
Both: □
SECTION A – PERSONAL DETAILS
Contact Details(Dr/Mr/Mrs/Ms/Miss)
Please delete as appropriate / Forename(s) / Surname
Previous Surname
Address
Postcode
Contact email / Daytime Contact Number(s)
Are you free to remain in and take up employment in the UK? / Yes/No
National Insurance Number
SECTION B – INFORMATION RELATING TO THE SELECTION PROCESS
Education and TrainingChildcare/Classroom Assistant Qualifications
Full Title of Course Undertaken
Examples
Early Years Care & Education
Diploma in Nursery Nursing / Level of Exam
NVQ III
Diploma / Examining Body
CACHE
NNEB / Grade
Pass / Month/Year Obtained
June 1993 / Month/Year Expected
June 2008
Original documentary evidence will be required from the successful candidate. Please include courses successfully completed and/or currently being undertaken.
Post Primary School Education (for example GCSE/GCE etc)Subject
Examples
Maths
Word Processing (Parts 1 & 2) / Level of Exam
GCSE
Stage 2 / Examining Body
NISEAC
RSA/OCR / Grade
C
Pass / Month/Year Obtained
June 1993
January 2000 / Month/Year Expected
Original documentary evidence will be required from the successful candidate. Please include courses successfully completed and/or currently being undertaken.
Higher EducationName of University or College / Dates / Qualification/Degree Awarded / If honours, state class and division
Main/subsidiary subjects studied in each year / 1st Year / 2nd Year / 3rd Year / 4th Year
SECTION B – INFORMATION RELATING TO THE SELECTION PROCESS
Employment (Current / Most Recent)Name and address of employer / Position / Dates (dd/mm/yy) / Reason for leaving
From / To
Salary / Notice required / Duties & Responsibilities
Experience (Detail current and previous experience, beginning with the current)
Childcare / Classroom Assistant Experience
Name and Address of employer, including type of employment
(eg Creche, Playgroup, School) / Type of Assistants, inc type of children worked with (eg Special Needs, P1, toddlers, babies) / Period of Employment
Dates / Paid voluntary or Training Placement / No of children worked with / Ages of children worked with / Reason for Leaving (please specify)
From
dd/mm/y / To
dd/mm/yy
Employment
Other Non –childcare Experience (Please list most recent first)
Name and address of employer / Job title/Grade / Dates (dd/mm/yy) / Main duties & responsibilities
(please state if paid, voluntary or training placement) / Reason for leaving
From / To
CHILD PROTECTION (Please note this post involves ‘regulated activity’ as defined under Safeguarding Vulnerable Groups (NI) order 2007 (see notes of guidance)
Are you aware of anything in your employment or personal history that would render you unsuitable to work with children and young people? YES / NO
If Yes, please provide details below.
Gaps in Employment
Please provide information below to explain any gaps in your employment history
Transport
Do you hold a current driving licence? YES / NO
If YES, please indicate category of licence
Do you have access to a suitable vehicle (appropriately maintained and insured for Board business) that will enable them to carry out the mobility requirements of the post in an efficient and effective manner and thus meet this essential criterion? YES / NO
or
Can you satisfy the employer that you have access to an appropriate alternative form of transport that will enable you to carry out the mobility requirements of the post in an efficient and effective manner and thus meet this essential criterion? YES / NO
If YES please provide information to support your answer in the box below
References
Please give the names and address of two referees, one of whom should be able to comment on your suitability to work with children /young people in an educational setting and/or your professional ability. Prior consent of referees should be obtained. References must not be submitted with this form. The Board of Governors will seek references from present/previous employers for all posts involving ‘regulated activity’.
Referee 1 (Current/Recent employer) / Referee 2
Name:
Address:
Telephone Number:
Capacity in which you know this person: / Name:
Address:
Telephone Number:
Capacity in which you know this person:
Position Held: / Position Held:
Email address: / Email address:
Please note – Any family member or person involved in the recruitment process for the post for which you are currently applying cannot act as a referee.
SECTION B – INFORMATION RELATING TO THE SELECTION PROCESS
Please use the space below to provide evidence as to how you meet the essential and desirable criteria for this post. You should outline the skills and experience you have gained, (either in paid work, unpaid/voluntary work, work at home, through your studies, through your leisure activities), which you think are relevant to the job, and which you believe makes you suitable for the post.
By the agreed date of taking up duty the applicant must have:
Essential Criteria:
· NVQ Level 3 in Children’s Care Learning and Development, or equivalent qualifications as recognised by the EA South Eastern Region
· Experience in a paid capacity of working as a classroom assistant in a primary school setting
· Experience of working with children with Special Educational Needs in any primary 1 – 7 class
· Good communication skills, both written and oral
· Reliable, patient, sympathetic and able to show empathy
· Ability to respect confidentiality
Desirable Criteria
· A minimum of 3 months experience in a paid capacity of working as a Classroom Assistant in a primary school
· Knowledge of the Northern Ireland Curriculum at primary school level
· Competent ICT skills to enhance children’s learning
The criteria may be enhanced. All qualifications will be checked prior to appointment.
Curriculum Vitae will not be accepted
DECLARATION
I declare that to the best of my knowledge and belief all the information recorded in this application form is true.
Signed:______Date: ______
EQUAL OPPORTUNITIES MONITORING QUESTIONNAIRE
Ref: CA/AB
Job Title: Classroom Assistant (SEN) Job A & B
PRIVATE & CONFIDENTIAL
GUIDANCE NOTES
We are an Equal Opportunities employer. We aim to provide equality of opportunity to all persons regardless of their religious belief; political opinion; sex; race; age; sexual orientation; or, whether they are married or in a civil partnership; or whether they are disabled; or whether they have undergone, are undergoing or intend to undergo gender reassignment.
We do not discriminate against our job applicants or employees on any of the grounds listed above. We aim to select the best person for the job and all recruitment decisions will be made objectively.
In this questionnaire we will ask you to provide us with some personal information about yourself. We are doing this for two reasons.
Firstly, we are doing this to demonstrate our commitment to promoting equality of opportunity in employment. The information that you provide us will assist us to measure the effectiveness of our equal opportunity policies and to develop affirmative or positive action policies.
Secondly, we also monitor the community background and sex of our job applicants and employees in order to comply with our duties under the Fair Employment & Treatment (NI) Order 1998.
You are not obliged to answer the questions on this form and you will not suffer any penalty if you choose not to do so.
Nevertheless, we encourage you to answer the questions below. Your identity will be kept anonymous and your answers will be treated with the strictest confidence. We assure you that your answers will not be used by us to make any unlawful decisions affecting you, whether in a recruitment exercise or during the course of any employment with us. To protect your privacy, you should not write your name on this questionnaire. The form will carry a unique identification number and only our Monitoring Officer will be able to match this to your name.
PLEASE COMPLETE THE FOLLOWING SECTIONS: TICK BOXES AS APPROPRIATE.
AGE: Please enter your date of birth: ____/_____/______(eg. 05/08/1964)SEX:
Please indicate your sex by ticking the appropriate box below:
Male: ÿ
Female: ÿ
COMMUNITY BACKGROUND:
Regardless of whether they actually practice a particular religion, most people in Northern Ireland are perceived to be members of either the Protestant or Roman Catholic communities. Please indicate the community to which you belong by ticking the appropriate box below:
I am a member of the Protestant community ÿ
I am a member of the Roman Catholic community ÿ
I am a member of neither the Protestant or Roman Catholic Community ÿ
If you do not answer the above question, we are encouraged to use the residuary method of making a determination, which means that we can make a determination as to your community background on the basis of the personal information supplied by you in your application form/ personnel file.
RELIGIOUS DENOMINATION
Roman Catholic ÿ Church of Ireland ÿ Buddhist ÿ Jewish ÿ Muslim ÿ
Presbyterian Church of Ireland ÿ Methodist ÿ Hindu ÿ Sikh ÿ
Other Christian ÿ Another Religion ÿ None ÿ
Note: If you answer these questions about community background and sex you are obliged to do so truthfully, as it is a criminal offence under the Fair Employment (Monitoring) Regulations (NI) 1999 to knowingly give false answers to these questions.
RACE, COLOUR, ETHNICITY, NATIONAL ORIGINS, NATIONALITY:
My Nationality is: ______
Please indicate your race or colour or ethnic or national origins:
White ÿ Chinese ÿ
Irish Traveller ÿ Indian ÿ
Pakistani ÿ Bangladeshi ÿ
Black Caribbean ÿ Black African ÿ
Black Other ÿ
Mixed ethnic group (state which): ______
Any other ethnic group (state which): ______
NATIONALITY
Please specify ______
DISABILITY:
Under the Disability Discrimination Act 1995 a person is deemed to be a disabled person if he or she has a physical or mental impairment which has a substantial and long-term adverse effect on his or her ability to carry out normal day-to-day activities. Please note that it is the effect of the impairment without treatment which determines whether an individual meets this definition.
Do you consider that you are a disabled person? Yes:ÿ No:ÿ
If “yes”, please indicate the nature of your impairment by ticking the appropriate box or boxes below:
Physical impairment, such as difficulty using your arms or mobility issues ÿ
which means using a wheelchair or crutches.
Sensory impairment, such as being blind or having a serious visual impairment ÿ
or being deaf, or having a serious hearing impairment
Mental health condition, such as depression or schizophrenia ÿ
Learning disability or difficulty, such as Down’s Syndrome or dyslexia, or ÿ
Cognitive impairment, such as autistic spectrum disorder
Long-standing or progressive illness or health condition, such as cancer, HIV infection, ÿ
diabetes, epilepsy or chronic heart disease
Other (Please specify):
SEXUAL ORIENTATION:
My sexual orientation is towards:
Persons of a different sex to me: ÿ
Persons of the same sex as me: ÿ
Persons of both sexes: ÿ
MARITAL STATUS/ CIVIL PARTNERSHIP STATUS:
Are you married or in a civil partnership?
Yes: ÿ No: ÿ
DEPENDENTS/ CARING RESPONSIBILITIES:
Do you have dependants, or caring responsibilities for family members or other persons?
Yes: ÿ No: ÿ
Are your dependents or the people you look after: (please tick the appropriate box or boxes)
A child or children: ÿ
A disabled person or persons: ÿ
An elderly person or persons: ÿ
Other: ÿ
If “other”, please specify: ______
ADVERTISING
Please name any newspapers and/or websites where you learned of this job:
………………………………………………………………………………………………………………..
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