2-4 Page Street
London
NW7 2EU
Tel: 020 8203 4294 (Ext. 312)
Fax: 020 8202 4527
/
Please complete this form in black ink, accurately and in full. Please write in block capitals
POSITION APPLIED FOR:PERSONAL INFORMATION
Surname: / Title: / Mr / Mrs / Miss / Ms /Other…………….
Forenames: / Former Name:
Address: / Home Tel. No:
Mobile No:
Fax No:
Post Code: / E-mail:
Date of Birth:
DCSF No: / Are you a British citizen? Yes / No
If not, do you require a work permit to work in Britain? If no, please explain.
Yes / No
QTS No:
GTC No:
NI No:
This post is exempt from the Rehabilitation of Offenders Act 1974, therefore all convictions, including those regarded as ‘spent ‘ must be declared. Do you have any convictions? If yes please detail separately and in a sealed envelope marked confidential. / YES / NO
Where did you see this position advertised? Newspaper Name of Newspaper ......
Website Name of Website ......
Other Specify ......
EMPLOYMENT HISTORY to date
Employer, School / AgeRange / Full/Part time / Subject specialism (if appropriate) / B/G/Mixed / From / To
Present Salary / Spinal Point / Incentive/Other allowances
Candidates are invited to attach a supporting statement with this application to highlight their personal suitability for this post.
TEACHING PRACTICE (If appropriate - First Appointments Only)School and LEA / AgeRange / Subject(s) taught / B/G/Mixed / From / To
EDUCATION TO DATE
Secondary School
(Name and Location) / From / To / Examinations Passed
(GCSE or equivalent) / ‘A’ Level & beyond
University/College
(Name and Location) / From / To / Full/Part time / Qualifications gained (with dates)
Other qualifications (long courses over past 5 years) / From / To / Full/Part time / Location
REFERENCES
Please give the names and addresses of two professional referees, one of whom must be your current or most recent employer. References from friends or relatives will not be accepted. References will be taken up before interview. We may approach previous employers for information to verify experience, qualifications or salary. We will ask your current or previous employerabout disciplinary offences relating to children including those for which the penalty is time expired. We will ask about child protection concerns, and the outcome of any enquiry or disciplinary procedure.
Mr/Mrs/Miss/Ms/Other / Mr/Mrs/Miss/Ms/Other
Name: / Name:
Address: / Address:
Daytime Tel. No: / Daytime Tel. No:
Email Address: / Email Address:
Occupation: / Occupation:
Providing false information is an offence and could result in the application being rejected or summary dismissal if the applicant has been selected, and possible referral to the police.
DECLARATION
Signature of Applicant: / Date:
When are you available to take up the post if appointed?
Canvassing members of the school Governing Body, directly or indirectly, will disqualify the candidate concerned.