Plimmerton School - Teaching Position Application Form

Application Closing Date: 4pm Monday 3 April 2017

Important Notes for Applicants on Final page

Full Name:
Full Postal Address:
Contacts: / Home - / Work - / Mobile -
Email -
Maiden name (if applicable) or any other name(s) known by:
Teaching position(s) you wish to be considered for:
Fixed-term teacher position - Commences 1 May 2017, ends 20 December 2017
Year levels you wish to be considered for:
This position is in a Year 7 & 8 Classroom
Are you a New Zealand citizen? Yes / No
If “No” do you have either residency or a current work permit? Yes / No
Have you ever had a criminal conviction? (Refer to notes for applicants) Yes / No
If “Yes” please detail:
Are you awaiting sentencing or have charges pending? Yes / No
If “Yes” please detail:
Have you ever been the subject of concerns involving student safety? Yes / No
If “Yes” please detail:

Have you any injury or medical condition which the tasks of a full-time teaching position may aggravate or contribute to? Yes / No

If “Yes” please detail:

Teacher Registration:

/

Number - Status - Expiry Date -

Teaching Related Qualification(s):

Name of Qualification: / Location / Year completed

Employment History

/ Please outline your most recent teaching experiences beginning with current or latest employment.
Period Worked: / School / Employer: / Position Held: / Reason for Leaving:

Referees

/ Please provide the names of three people who could act as referees for you. These referees should be able to attest to your work performance in relation to a teaching position. If you have included written references, reports or quotes from people other than those listed below, please note that we may contact the writers of these.
Name: / Contact details: (organisation & address) / Phone Contacts: / Relationship:
(e.g. Principal)
Hm:
Bus:
Mob:
Hm:
Bus:
Mob:
Hm:
Bus:
Mob:
Authority to approach other referees:
I authorise the Board, or nominated representative, to approach persons other than the referees whose names I have supplied, to gather information related to my suitability for appointment to the position. / Yes / No
I authorise the Board, or nominated representative, permission to access any information held by the Education Council of Aotearoa New Zealand (EDUCANZ) or any other educational organisation, including information regarding matters under investigation, to gather information related to suitability for appointment to the position. / Yes / No
Proof of Identity:
The Vulnerable Children Act 2014 requires that before an appointment can be made core workers in schools, which includes teachers, are required to provide originals of two types of identification. One must include photo ID (e.g. passport, New Zealand driver licence) and the other a record of ID (e.g. birth certificate, bank statement, bill).
Are you able to provide suitable proof of identity if selected as a preferred candidate for a position? / Yes / No
I certify that
●the information I have supplied in this application is true and correct.
●I confirm in terms of the Privacy Act 1993 that I have authorised access to referees.
●I know of no reason why I would not be suitable to work with children/young people.
●I understand that if I have supplied incorrect or misleading information, or have omitted any important information, I may be disqualified from appointment, or if appointed, may be liable to be dismissed.
●I understand that the tone of this application form is a bit scary in places because the people at Plimmerton School want to make sure that the appointment process meets all legislative obligations required of them, and that actually they are quite nice people.
Signature:Date:
(For applications sent in by email: you may enter your full name instead of your signature as verification)

PLIMMERTON SCHOOL

Teaching Position Application Form

IMPORTANT NOTES FOR APPLICANTS

  1. Please fully complete this form personally. Please make sure you sign and date the form. We are happy to accept applications as either emailed or posted documents.
  2. Attach a curriculum vitae (CV). If you wish, you may include a separate covering letter or documentation indicating your knowledge, skills and attributes in relation to the Person Specification.
  3. Attach at least onewritten reference or observation report. Please note that we may contact the writers of the written references.
  4. Your application should clearly state the relevant qualifications that you hold. Copies (no originals) of qualification certificates are not required but may be attached should you wish. If successful in your application you will be required to present originals as proof of qualifications.
  5. If you are shortlisted for an interview you may bring whānau/support people to your interview at your own expense. Please advise if this is your intention.
  6. Failure to answer all questions truthfully may result in any offer of employment being withdrawn or appointment being terminated if any information is later found to be false.
  7. All appointees will be asked to provide evidence of, or give consent to a police vet. It is a requirement in the Education Sector for all employees to be vetted. Presentation of a current teacher practicing certificate confirms that a satisfactory police vet has been undertaken.
  8. The disclosure of criminal convictions is required under the following guidelines:

a) In terms of a Criminal Conviction, the Criminal Records (Clean Slate) Act 2004 provides that certain convictions do not have to be disclosed providing:

○You have not committed any offence within 7 (consecutive) years of being convicted for the offence; and

○You did not serve a custodial sentence* at any time (this would then exclude serious offences such as murder, manslaughter, rape and causing serious bodily harm); and

○The offence was not a specified offence (specified offences are in the main sexual in nature); and

○You have paid any fines or costs.

* Custodial sentences include a sentence of preventative detention and corrective training. Non-custodial sentences include fines, reparation orders, community-based sentences and suspended sentences.

Please note that you are not obliged to disclose convictions if you are an eligible individual under the Clean Slate Act, but can do so if you wish. If you are uncertain if you are eligible contact the Ministry of Justice.

b) Under the Vulnerable Children Act 2014 core workers in schools, which includes teachers, will not be covered by the Clean Slate Act. All serious sexual or violent offenses against children will be included in their police vetting results. The Act makes it unlawful to employ people with convictions for these offences, unless they have an exemption.

  1. The school will hold this application form and supporting documents. The information provided will only be used for the purposes of appointing for this position. In accordance with the provisions of the Privacy Act 1993 confidentiality will be respected and you may access information you provided.
  2. Please provide a stamped envelope if you would like your CV returned.