APPLICATION FORM

Application for Post of: / Part Time Teaching Assistant
1. PERSONAL DETAILS (Block letters please)
Surname / Forenames
Telephone Number / Email Address
Home Address
2. SCHOOL, HIGHER EDUCATION AND ANY POST GRADUATE QUALIFICATIONS
Place of Study
(School, University, College, etc) / Date
From / Date
To / F/T
OR
P/T / Qualification
With Grade, Class/
Division / Subject / Age Range
3. PROFESSIONAL CAREER - CURRENT POSITION
Current Employer / Job Title
Further Details
4. PREVIOUS CLASSROOM EXPERIENCE (in chronological order).
Name and Type of School / Name of LEA / Date
From / Date
To / Class Size / Ages / F/T or
P/T / Extra Responsibilities
5. OTHER PAID EMPLOYMENT
Employer / Position / Duties / From / To
6. GIVE A BRIEF STATEMENT IN REGARDS TO YOUR INTEREST IN THE POSITION FROM BOTH PROFESSIONAL AND PERSONAL PERSPECTIVES
7. PLEASE PROVIDE DETAILS OF NOTABLE ABSENCE IN THE PAST 2 YEARS
Dates / No of Periods of Absence / Total number of days
8. CRIMINAL CONVICTIONS
Tomorrow's Generation is committed to providing a safe and secure environment for all children and young people who come into contact with its employees. Policies concerned with the recruitment, selection and monitoring of employees positively reflect this commitment.
Have you ever been convicted of a criminal offence? Yes or No
Please complete Rehabilitation Document attached - enhanced DBS checks are made for all employees who have unsupervised access to children.
9. REFEREES
REFEREE 1. / REFEREE 2.
Name / Name
Address / Address
Tel. No. / Tel. No.
E-mail / E-mail

I DO HEREBY CERTIFY THAT ALL STATEMENTS MADE BY ME IN THIS APPLICATION ARE TRUE AND

CORRECT TO THE BEST OF MY KNOWLEDGE, INFORMATION AND BELIEF .

SIGNED / DATED

Please email your completed application form to:

STRICTLY PRIVATE AND CONFIDENTIAL

REHABILITATION OF OFFENDERS ACT 1974

Because of the nature of the work for which you are applying this post is exempt from the provisions of section 4(2) of the Rehabilitation of Offenders Act 1974 in accordance with the Rehabilitation of Offenders Act 1974, (Exceptional) Order 1975 as amended by the Rehabilitation of Offenders Act 1974 (Exceptions) (Amendment) Order 1986.

Applicants are therefore not entitled to withhold information about convictions which for other purposes are 'spent' under the provisions of the Act and in the event of employment any failure to disclose such convictions could result in dismissal or other disciplinary action by the Council. Any information given will be completely confidential and will be considered only in relation to an application for positions to which the Order applies.

Please answer the following questions

Please print your full name
(Block Capitals)
Have you been convicted of a criminal offence in the past / YES / NO
If yes, please give full details
Have you used or do you currently use any other surname(s) / YES / NO
If YES, please state name(s)
Signed / Dated
Position Applied For
Emergency Contact Information
Name / Contact Tel No
Address / Relationship
Signed / Dated

Tomorrow's Generation –