CONFIDENTIAL

CATHOLIC EDUCATION SERVICE

GUMLEY HOUSE CONVENT SCHOOL F.C.J.

(A CatholicSchool in the Trusteeship of the Faithful Companions of Jesus)

TEACHER APPLICATION FORM

(Before completing this form, please see Notes to Applicants on page 4)

PERSONAL DETAILS

APPLICATION FOR THE POSITION OF TEACHER OF MODERN FOREIGN LANGUAGES

AT GUMLEY HOUSE CONVENT SCHOOL FCJ

IN THE LONDON BOROUGH OF HOUNSLOW

AND IN THE ARCHDIOCESE OF WESTMINSTER

PRESENT POST …………………………………………………………………………………………………

PRESENT SALARY ………………………………………… POST THRESHOLD Yes / No ……UP 1/2/3

Surname …………………………………………………………………………Title …………………………

Forenames ………………………………………………………………………………………………………….

Marital Status …………………….………………………Date of Birth …..…..../……...../…..………….

Religious Denomination……………..……………………Ethnic Origin …………………………………

Address……………………………………………………………………………………………………..

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

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

Home Tel no (……………)………………………....School Tel no (……………)…….…………………….

Mobile no ……………………………………………..Email …………………………………………………..

Department for Education Reference No. ……………………………………………………………..

National Insurance No. …………………………………………………………………………………………….

Date of Qualification as a Teacher …………………………………………………………………………………

If you are registered disabled, please state your number …………………………………………………………..

POST-16 EDUCATION AND TRAINING

Please give information about any education received in this country or abroad, and qualifications obtained including degrees, with class and division, and Teacher’s Certificates.

Establishment
attended / Full or
Part –time / Qualifications / Dates attended
From / To

TYPE of teacher training: Middle Secondary Primary (Junior, Infant or Nursery)

(PLEASE TICK APPROPRIATE BOX(ES))

STATE subjects in which you are qualified to teach, and other subjects you wish to teach and any other specialisms you have which may be relevant to your application:

Do you have the Catholic Teachers Certificate or equivalent?YES / NO

OTHER recent courses and INSET in which you have been involved in the past 3 years and which you consider relevant to this post: (please state length of course/s)

EXPERIENCE

Please give further details of experience in chronological order.

(Students seeking a first appointment should give details of teaching practice)

Education
Authority
Or
Employer / Name & type of school or institution.
(state whether Nursery, Primary, Secondary, Comprehensive, Selective etc) / Age range /Single sex or mixed / Approx. number on roll / school group / Post held
& Salary grade
(please state whether full-time or part-time) / Dates
From / To
(Serving teachers should indicate where and when probationary year was
satisfactorily completed in the column above )
DETAILS of other employment and unpaid experience (for example family duties, voluntary work etc) which you wish to be taken into consideration.
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Please state where you learned of this vacancy……………………………………………………………………...

REFERENCES

Please nominate up to three referees, one of whom should be your Parish Priest in the case of a Catholic applicant, and if in employment, one should be your present employer.

Name…………………………………………………………….Designation…………………………………….

Address ………………………………………………………… Telephone……………………………………...

………………………………………………………………….Fax …………………………………….……...

Name…………………………………………………………….Designation…………………………………….

Address ………………………………………………………… Telephone……………………………………...

………………………………………………………………….Fax …………………………………….………

Name…………………………………………………………….Designation…………………………………….

Address ………………………………………………………… Telephone………………………………………

………………………………………………………………….Fax……...……………………………………...

Do you agree to your present employer being contacted concerning this application?YES NO

NOTES TO APPLICANTS
  • Before signing this form, please ensure that every section has been completed.
  • The form should be returned as instructed in the details of the post.
  • Candidates are invited to make any statement in support of their application.
  • Candidates are reminded that this is an application for a post in a CatholicSchool where the Governors are the employers and that the post will be subject to terms and conditions of the Catholic Education Council’s Model Contract of Employment.
REHABILITATION OF OFFENDERS ACT, 1974

For teaching and lecturing posts, you are required before appointment to disclose any conviction, caution or binding over, including “spent convictions”, under the terms of the Rehabilitation of Offenders Act 1974 (Exemptions) Order 1975.

Disclosure will only be required if following interview it is considered that you are the most suitable applicant for the post.

Please sign here if you agree that the appropriate enquiry might be made.

Signature: ………………………………………………………

STATEMENT

To the best of my knowledge and belief, the information contained in this form is accurate.

Signature: ………………………………………………………Date: ………………………………….

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