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Principal Designate
Application Form

Closing Date : midday, March 24th 2016

North East Futures UTC Trust : Appointment of Principal

Guidance on completing this form

This form is designed to enable candidates to demonstrate the extent to which their experience to date meets the requirements of North East FuturesUTC Trust.

We expect candidates to complete all the sections.

  1. Please note that no curriculum vitae or letter of application is required.
  1. Canvassing, directly or indirectly, will disqualify.
  1. Teachers aged 55 and over are advised that, if they have previously accepted early retirement from a teaching post, and, if appointed to a new post, they should advise the Paymaster General, the Department of Education and their previous employer of their change of circumstances.
  1. In line with the Equality Act 2010 and the Education (Health Standards) (England) Regulations (2003) the successful candidate will be required to complete a medical questionnaire, and may then be required to undergo a medical examination.

When complete, this form should be e-mailedby midday, March 24th 2016, for the attention of Bob Paton CBE, Chair, to :

  1. Candidates should ensure that referees named are able to comment on their achievements and on their knowledge and understanding of current educational issues.
  1. The application form should be completed in Arial font (no smaller than size 11) and sent by email, as above.

This application form is also available electronically at

Application for the post of Principal, North East Futures UTC

Section One - Personal Details

Surname: Title Mr/Mrs/Miss/Ms or other:
Forename: Former names (if applicable):
Home address:
Postcode:
Telephone number (Home): (Work):
Mobile Telephone number: Email address:
Please state your preferred method for us to contact you during the working day:
Work telephone / mobile telephone / email address (delete as appropriate)
Teacher Reference Number (DfE number): / National Insurance Number:
If you are not a European Citizen, please state if you require a work permit: Yes / No
If yes, please specify your circumstances:
Do you hold Qualified Teacher Status?
If Yes, please give date of the award.
QTS Certificate number (if available)
Have you successfully completed a period of induction as a qualified teacher in this country where the DfE required this?
Yes / No / If Yes, please give date of completion, and LA where induction was completed:
Do you hold NPQH? Yes / No
If Yes, please give date awarded:
Are you subject to any conditions or prohibitions placed on you by the DfE National College for Teaching and Leadership (NCTL) (or any other body in the UK)?
If Yes, give full details (continuing on additional sheet as required)
Do you have an enhanced DBS (CRB) check completed in the last two years?Yes /No
If yes, please give DBS (CRB) reference number and date
Are you currently registered with the DBS Update Service? Yes / No
Section Two - Current Employment
Current Post Details:
Job title:
Employer’s name and address:
Telephone number:
Email address:
Date appointed: NOR (if appropriate):
Grade/allowances (if appropriate) :
Leadership point (if appropriate) :
Salary:
Date available to take up Principal Designate post:
Section Three – Confidential References

Name, address, telephone number, email address and status of TWOprofessional referees.

References will be taken up before interview. References will not be accepted from relatives or from people writing solely in a personal capacity.

1)Name and Address
Telephone Number:
Mobile Number:
Email address:
2)Name and Address
Telephone Number:
Mobile Number:
Email address:
Section Four – Education/Qualification Details

Please provide information in full relating to your education :

School/College/University
(Name & Address) / Subject(s) / Level (e.g. GCSE, A Level,
Degree etc) / Grade / Date Gained
Section Five – Details of Further Training and Professional Development

Please list any training/professional development you have received in the last three years which has helped you to prepare for/undertake the role of Principal (including collaborative work/work with other organisations relevant to this post) :

Title of Course/Nature of
Development Opportunity / Duration of
Training/Development / Brief outline of Course/Development
Opportunity / Date(s)

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Section Six - Career Record

Please list in unbroken chronological order, all posts that you have held since leaving school, including those outside education, with an

explanation of any breaks. Please start with the most recent post. Please ensure you have included a month and year in the ‘date from’ and ‘date to’ boxes.

Date
From / Date
To / Name of employer / Name / type of school/college
Include age range, mixed or single sex(If appropriate) / Approx. NOR
(If appropriate) / Post Title, Grade or Scale (and full or part time) / Reason for leaving or break in employment

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Section Seven – Periods of Non-Employment

From / To / Reason

In the following sections (eight and nine) Candidates are invited to provide information about how they meet the job specification (in section 8), and are invited to set out their vision for the UTC in section 9; separate letters of application are not required.

Section Eight - Personal Statement

Please provide, on no more than two sides of A4 (Arial font, minimum point 11) further evidence and information related to the job description and person specification. This should concentrate on your key skills and achievements, and provideevidence of outcomes and impact (Please do not attach a CV).

Section Nine - Vision and any other information

Please set out in the box below your vision for the UTC and outline how you would successfully lead this school, alongside any further information you feel would be helpful to us in considering your application.The text box will expand as you write, but you should aim to fill a maximum of one and a half sides of A4. (Arial font, minimum point 11).

EMPLOYMENT CHECKS

Rehabilitation of Offenders Act 1974(Exemptions) Order 1975

Teaching with the privileged access it gives to children is an exempted occupation under the Rehabilitation of Offenders Act 1974 (Exemptions) Order 1975. You are therefore required to declare any criminal convictions, cautions, reprimands or final warnings including those that are 'spent'. The amendments to the Exceptions Order 1975 (2013) provide that certain 'spent' convictions and cautions are 'protected' and are not subject to disclosure to employers, and cannot be taken into account. Guidance and criteria on the filtering of these cautions and convictions can be found on the Disclosure and Barring Service website:.

Do you have any convictions, cautions, reprimands or final warnings that are not "protected" as defined by the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (as amended in 2013)? Yes No

If YES, please give details of any convictions (and the dates) on a separate piece of paper and place in a sealed envelope marked for the attention of the Chair of the Panel.

North East Futures UTC Trust is committed to safeguarding and promoting the welfare of children and young people and expects all staff and volunteers to share this commitment. If you are ultimately offered the position you will be required to undergo an Enhanced DBS check, and will be asked to complete an application form, or provide information to allow the school to check your status on the DBS Update Service.

With effect from 17th June 2013 DBS certificates are only issued directly to the applicant. You will be required to show your certificate to the school who will record the Disclosure number and issue date and retain these on your personnel record. In line with the DBS Code of Practice the school will not take and retain photocopies of the full DBS Certificate.

Please state where you saw the advertisement for this post:

Please state, whether to the best of your knowledge, you are related to a member of the North East Futures UTC Project Steering Group or the North East Futures Trust. If YES, please state the nature of the relationship and the name.

I understand that if I am appointed, personal information about me will be computerised for personnel/employee administrative purposes including analysis for management purposes and statistical returns.

I confirm that I am not on The Children’s Barred List (previously List 99 and PoCA List), disqualified from working with children, or subject to sanctions imposed by a regulatory body, e.g. the DfE,National College for Teaching and Leadership.

The information on this form is correct and complete to the best of my knowledge and belief.

Signature of candidate

Date …………………..

North East Futures UTC Trust : Appointment of Principal

Name ...... Date ......

EQUAL OPPORTUNITIES – MONITORING SUPPLEMENT

THIS PAGE IS CONFIDENTIAL AND WILL NOT BE SEEN BY THE SELECTION PANEL

D o B ……………. M/F ….. Age ………… Previous/Last name(s)……………………….

Do you wish to apply for this post on a job share basis?Yes/No

Do you have a disability?Yes/No

What special adaptations might you need to carry out the job/attend for interview?

......

Ethnic Origin(please circle as appropriate)

How would you describe your ethnic origin? (For this purpose “ethnic origin” means that of a person who themselves, or whose parents and/or grandparents were born within one of the groups below)

a)White

British/Irish/Any other white background (please state)………………………………………

b)Mixed

White and Black Caribbean/White & Black African/White & Asian/Other mixed

background (please state) ……………………………………………………………

c)Asian or Asian British

Indian/Pakistani/Bangladeshi/Other Asian background (please state) ……………………

d)Black or Black British

Caribbean/African/Other black background (please state) ……………………………….……

e)Chinese or other ethnic group

Chinese/Any other (please state) ……………………………………………….

f)I do not wish to give this information

Religion(please circle as appropriate)

a)None/Christian (inc Church of England, Catholic, Protestant and all other Christian denominations)/Buddhist/Hindu/Muslim/Sikh/Jewish/Other (please state) ……………………………………………………………………………………………

b)I do not wish to give this information

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