Healing School – A Science Academy

Teaching Post Application Form

/ HEALING MULTI-ACADEMY TRUST
Low Road, Healing, Grimsby, N E Lincs, DN41 7QD
Post applied for ……………………………………………………………………
PERSONAL DETAILS
1. Title / Surname / Forename(s)
2. Home Address
Post Code
3. Telephone / Home / (_____) / DfE No.
School / (_____) / National Insurance No.
Mobile / E-mail address
Do you have the right to work in the UK? Yes No
Have you worked overseas for a period of Yes No
12 months or more in the last 10 years?
If yes do you hold an Overseas Criminal Yes No
Record Certificate?
4. PRESENT EMPLOYMENT
School
(name, type and Authority, include division if appropriate)
 Full Time /  Part Time / Number on roll / Ages taught
Responsibilities
POINTS ASSESSMENT
Date of Appointment / Salary / Mandatory Points / Discretionary Points / Total Points
5. RECORD OF ALL TEACHING EXPERIENCE/POSTS HELD
(EXCLUDING PRESENT POST) IN CHRONOLOGICAL ORDER, ie exact dates for all posts held
(STUDENTS SEEKING FIRST APPOINTMENT SHOULD ENTER DETAILS OF TEACHING PRACTICE)
Employing Authority
(inc. Division if appropriate) / School (name, type and age range) / Number on roll / Salary Point/Scale / Ages taught / Dates From / To
Full Time
Part Time
6. / State age group for which mainly trained
7. / (a) What is your principal teaching subject?
(b) For what other subjects are you appropriately trained or qualified?
8. EDUCATION (enter in chronological order)
Secondary School, Further & Higher Education / State whether full-time or part-time / Date of / Qualifications obtained and subjects passed with date in each case. If degree, state whether honours and give class and subjects.
Entering / Leaving
Note: If a course of full-time study for a degree extended over a period of four years, please state whether this was the normal period of the course.
9. / Qualifications other than a degree entitling you to rank as a graduate for salary purposes or if specifically recognised by the Department for Education. Please give particulars, with dates.
10. EDUCATIONAL COURSES ATTENDED IN THE LAST FOUR YEARS
Course / Date / Duration of Course
11. / Give a statement of any activities, not mentioned above, educational, sporting or extra-curricular, in which you have taken particular interest. Ability to play any musical instrument should be noted.
12. / (i) Details of previous Employment other than teaching. Give full particulars and dates
(ii) Additional information you wish to give in support of your application. (Use additional sheets if necessary)
13. / (a) What notice must you give to terminate your present employment
(b) When could you commence a new appointment
14. DISCIPLINARY/SAFEGUARDING ISSUES
Have you ever been subject to disciplinary proceedings or a written warning?
If so please give Details /  Yes /  No
Have you ever been subject to an investigation in connection with safeguarding? /  Yes /  No
If so please give Details
15. CRIMINAL CONVICTIONS
Have you a current criminal conviction or caution, i.e. one that is not spent? /  Yes /  No
If so please give Details
16. / Name and addresses of two persons from whom written references can be obtained
(one of whom must be the Principal/Headteacher of your current school)
(a) / Name / Tel No.
Address
E-mail address
(please provide where possible) / Status
(b) / Name / Tel No.
Address
E-mail address
(please provide where possible) / Status
NB. The School reserves the rights to verify claims made on this application form
I agree that during the course of any employment I will inform the Principal immediately of any conviction for a criminal offence (other than minor traffic and parking offences).
The particulars are correct to the best of my knowledge and belief:-
Signed: ………………………………………………. / Date: …………………………………………………
This application should be sent to:HR Department
Applicants offered an appointment will be subject to a Disclosure & Barring Service enhanced disclosure.
We have reluctantly adopted the practice of not acknowledging applications received. If you have not heard from us within six weeks of the closing date for applications, please assume that you were unsuccessful on this occasion. No further communication will be made.
/ Equal Opportunities Monitoring
Healing School -A Science Academy is committed to a policy of equal opportunities and it is our approach to select the right person irrespective of disability, race, colour, sex or marital status. Please complete this section of the form which is voluntary and will not be made available to people who read the application form itself. The form will be used to monitor the effectiveness of the equal opportunities policy.
THIS FORM IS NOT PART OF THE SELECTION PROCESS
Last Name / First Name(s)
Post applied for / Date
Department / Date of Birth
My ethnic origin is: / Age range:
White / (please tick)
White British /  A1 / Under 25 / 
White Irish /  A2 / 25-34 / 
Any other White background /  A3 / 35-44 / 
Mixed / 45-54 / 
White and Black Caribbean /  B1 / 55-64 / 
White and Black African /  B2 / 65 or over / 
White and Asian /  B3
Any other mixed background /  B4 / Are you:
Asian, or Asian British / Male / 
Indian /  C1 / Female / 
Pakistani /  C2 / Married / 
Bangladeshi /  C3 / Single / 
Any other Black background /  C4
Black or Black British / Is there anyone dependent on you for Care?
Caribbean /  D1 /  Yes /  No
African /  D2
Any other Black background /  D3
Other ethnic groups
Chinese /  E1
Any other ethnic group /  E2
Do you have a disability/health problem, which affects you in employment? /  Yes /  No
If so, please give brief details
Have you any special requirements for interview (e.g. sign language, interpreter, wheelchair access):
If you would like additional help with completion of the application form please ring the Principal’s PA.
Where did you see this post advertised?
School Website
TES Online
TES Paper
Jobs Go Public
Grimsby Evening Telegraph
Other (please specify) ……………………………………………………………………….

APPLICATION INFORMATION IMPORTANT

PLEASE RETURN YOUR APPLICATION AT THE EARLIEST CONVENIENCE AS APPLICATIONS RECEIVED AFTER THE CLOSING DATE MAY NOT BE CONSIDERED

By email -

By post - HR Department, Healing Multi-Academy Trust

Low Road, Healing, Grimsby, DN41 7QD

Every Child Matters – Safer Recruitment