Education & Leisure

EDUCATION & LEISURE

PLEASE NOTE:

This form should be completed and sent to the attention of the Corporate Director (Education & Leisure), Education & Leisure Department, Glanhwfa Road, Llangefni, Ynys Môn LL77 7EY.

The form to be carefully and fully completed using BLACK ink.

Application forms will not be accepted after closing date.

CANVASSING WILL DISQUALIFY.

Application For Post Of:HEADTEACHER

School:…………………………………………………………….

Name in Full (Surname First): …………………………………………………………………………………………………………………………………….

Address: ……………………………………………………………………………………………………………………………………………………………………

………………………………………………………………………………………………………………………………………………………………………………….

…………………………………………………………… Personal Telephone Number: ………………………………………………………………………..

National Insurance Number: ……………………………………………………………………………………………………………………………………….

1. SECONDARY EDUCATION

(a) Secondary School(s) attended …………………………………………………………………………………………………………………………………

(b) External examinations while at school:

Date / GCSE
CSE/O/A /

Subject

/ Grade / Date / GCSE
CSE/O/A /

Subject

/ Grade

2.KNOWLEDGE OF WELSH

(a) Ability to speak Welsh: …………………………………………………………………………………………………………………………………………..

(b) Ability to write Welsh: …………………………………………………………………………………………………………………………………………..

3. FURTHER EDUCATION: College of Education and/or University College and/or other F.E. Institution

(A)COLLEGE OF EDUCATION

(i)College attended: ……………………………………………………………………………………………………………………………………………

(ii)Main subjects of Certificate/Diploma Course: …………………………………………………………………………………………………..

(iii)Trained for:

(a) / Early Years/Nursery / ………………………………………. / (b) / KS1 / ……………………………………….
(c) / KS1/KS2 / ………………………………………. / (d) / KS2 / ……………………………………….
(e) / KS2/Secondary / ………………………………………. / (f) / Secondary / ……………………………………….

(iv)Certificate/Diploma: ……………………….…………….……. Class/Grade: ……………………………………………………………………

(v)Degree: ……….………………….……… Class/Grade: …………………..…………… Main subject(s): …………………………………….

(B)UNIVERSITY COLLEGE

(a) University College (Degree Course): ……………………………………………. ………………………………………………………………………..

Main subjects of Degree Course: ………………………………………………………………………………………………………………………………….

Degree (Class and Grade): ……………………………………………………………………….………………………………………………………………….

Higher Degree(s): ………………………………………………………………….……………… ………………………………………………………………….

(b) University College (Professional Course): ………………………………………………………………………………………………………………..

Main subjects of Professional Course: ………………………………………………………………………………………………………………………….

Trained for: / (a) / Primary / ……………………….. / (b) / Primary/Secondary / …………………………………….
(c) / Secondary / …………………………………….

Certificate/Diploma: ……………………………………………………………… Class/Grade: …………………..…………………………………………

(C) TECHNICAL COLLEGE/POLYTECHNIC: ………………………………………………………………………………………………………

Details of Course: ……………………………………………………………………………………………………………………………………..………………..

Degree/Diploma/Certificate: ……….………………………………………………….……….. Class/Grade: ……………………………………………

4. TEACHING EXPERIENCE (Present posts should not be shown: see (5) below)

Exact date of appointment / Exact date of termination / Name and type of school / Number on Roll / Local Education Authority / Ages of pupils taught / Status of post

5. PRESENT POST: COMPLETE EITHER (A) OR (B)

(A)IN A SCHOOL

Ysgol: ……………………………………………………………………….. Education Authority: ……………………………………………………………..

Number on Roll: ……………………………… Group: …………………………………………………………………………………………………………….

Your present status in the school: …………………………………………………………..……………………………………………………………………

(Any previous post in your present school should appear in (4) above)

(B)IN ANY OTHER INSTITUTION

Description: ………………………………………………………………………….. Employer: …………………………………………………………………

Your status: ………………………………………………………………………… Date: from …………………………………………………………………..

6. TOTAL TEACHING EXPERIENCE (do not include Teaching Practice)

Teacher (Main Scale) / …………………………………… / years / …………………………………… / months
Teacher (responsibility allowances) / …………………………………… / years / …………………………………… / months
Deputy Headteacher / …………………………………… / years / …………………………………… / months
Headteacher / …………………………………… / years / …………………………………… / months
Teaching experience other than Primary / …………………………………… / years / …………………………………… / months
______
TOTAL: / ……………………………… / years / ………………………………. / months
______

7. PERIOD(S) AFTER LEAVING SCHOOL NOT INCLUDED IN (4), (5) and (6) ABOVE

(dates; description; employer)

8. ANY OTHER RELEVANT DETAILS (e.g. courses; interests; prizes; honorary posts)

The back page may be used for a letter of application or for further details if so wished.

9. *NAMES AND ADDRESSES OF TWO PERSONS TO WHOM REFERENCE MAY BE MADE

…………………………………………………………………………………… / ………………………………………………………………………………………
…………………………………………………………………………………… / ………………………………………………………………………………………
…………………………………………………………………………………… / ………………………………………………………………………………………
…………………………………………………………………………………… / ………………………………………………………………………………………
…………………………………………………………………………………… / ………………………………………………………………………………………

Date: ……………………………………………… Signed: …………………………………………..………………………………………

*Officers of Anglesey LEA may not act as referees.

Have you retired under any pension scheme including Teachers Early Retirement arrangements?

YES/NO

This page for additional information or personal letter of application

DECLARATION OF RELATIONSHIP: To conform to the Standing Orders of the Isle of Anglesey County Council, the applicant should state below any family relationship, to any member or senior officer of the County Council.

GE/Ffurflen Gais Prifathro(awes) (Saesneg)