APPLICATIONFOR ATEACHING APPOINTMENT

Job Title
Secondary Subject
Where did you see this post advertised?
Please return form to: /
When could you take up duties if appointed?

Pleasereadall instructionscarefullybeforecompleting thisform.Pleasecomplete infullintype orblackink. We areunabletoacknowledgeapplications.Ifyouhavenotbeencontacted within14daysoftheclosingdate you canassumethat yourapplicationhasnotbeensuccessful.

Part A – PERSONAL DETAILS
Title
First Name
Surname
Address
Postcode
Telephone number
Email address
If applicable, do you need a work permit to work in this country?
YES / NO / N/A
If youhaveaworkpermit, pleasestateif thereareanylimitations/conditions/ expiry dateonthework permit.
National Insurance Number
Please indicate if you have a disability you want the school to take into account
YES / NO
Pleaseoutlinewhat assistance(if any)youneedduringtherecruitment andselectionprocess
DateofrecognitionasqualifiedteacherbytheDfE
DfENo.
GTCNo.
Haveyousuccessfullycompletedaperiodof induction/probation?
YES / NO
If yes,withwhichauthority?
Dateofcompletionof induction/probation?
Part B – EDUCATION AND TRAINING
1. Secondary Education
Detailsofsecondary/further education.Pleaselistallschools,colleges,etc.which you haveattended.
Name of establishment / Qualification gained / Grade / Dates
From / To

Please continue on a separate sheet if necessary. You will be asked to provide original proof of relevant qualifications if you are interviewed.

2. Higher Education/ Teaching Qualifications
Detailsofhigher education/teaching qualifications.Pleaselistall colleges,universitiesetc. whichyouhave attended.
Name of establishment
(school, university, etc) / Qualification gained & Subject / Grade/ Class / Dates
From / To
3. Higher Education/ Teaching Qualifications
Name of Professional Body / Was membership gained by examination / Membership grade / Date
4. Relevant In-Service Courses
Please give detailsofall relevantin-servicecoursesattended.
Courses / Qualifications gained / Dates
Part C – EMPLOYMENT
1. Present or most recent employment
Name and address of employer
Postcode
Telephone number
Post Held
Date started / Until
Basic salary
Other allowances
Key roles/Achievements
Reason for leaving
2. Full Employment history
Pleasecontinueon a separatesheetifnecessary.
Name and address of employer (including telephone number) / Date of employment / Position / Salary / Reason for leaving
Haveyouever been dismissed byanemployer?
YES / NO
Details
Part D – EXPERIENCE/ RELEVANT SKILLS/FURTHER INFORMATION
Usethissectiontoshowhowyoumeetalloftheshortlisting criteria for thejob assetoutin theperson specification,drawingon all aspectsofyour education,training and experience,including paid or unpaid employment,voluntarywork,and homeresponsibilities.Shortlistingwill beconducted onlyon the basisof written applications. Itisthereforeessentialthatall applicants, both internaland external,should completethissection of theapplication form.
Please continue on a separate sheet if necessary.
Part D – EXPERIENCE/ RELEVANT SKILLS/FURTHER INFORMATION
Part C – VERIFICATION OF EMPLOYMENT
Pleasegivenamesand addressesoftworefereeswhocan provideemploymentreferences.Onerefereeshouldbe your currentHeadteacher / Line Manager.
REFEREE 1 / REFEREE 2
Name / Name
Position / Position
Address / Address
Tel. No. / Tel. No.
Email / Email
Pleasetickthis boxifyoudonotwishtheschool toapproach your presentemployer until,and if,a firmoffer of employment hasbeenmade. Theschool normallytakesup referencesifyou havebeenshortlisted.Pleasenote thatwereservetherighttoapproach anyofyour previous employersfor referencesif necessary.
CRIMINAL CONVICTIONS
By law, spent convictions must be disclosed. Would you please give details of any criminal convictions (not including minor traffic offences), if you have no convictions please write ‘NONE’.
DECLARATION
I herebydeclarethatIhave understood and compliedwith therequirementslaiddown in thepreviousparagraph and I agreethattheinformation givenon thisform maybeused for registered purposesundertheDataProtection Act,1984. Ihavealsounderstood and complied with theprovisionsconcerning thedisclosureor criminal convictions.
Failureto discloseinformation orproviding deliberatefalseinformationtosupportyour applicationor canvassing, directlyor indirectly,anyonelikelytobeinvolved in theappointment processwilldisqualifyyou fromappointment or if appointedwill renderyou liabletodismissalwithoutnotice.
Name
Signature
Date

CONFIDENTIAL

ADDITIONAL DECLARATION OF INFORMATION

PERSONAL DETAILS
A checkonthepossibleexistenceand contentof acriminal recordwill normally berequested fromtheCriminal RecordsBureau aftera person hasbeen selected for appointmenttothispost. Refusal toagreetoa checkbeing madecould disqualify you from being considered for theappointment.
You arethereforeaskedtosign thestatementonthisdocumenttoconfirmyouragreement,ifyou areselected for theappointment,toacheckbeingmadeon anycriminal record applicabletoyou.
UndertheRehabilitationofOffendersAct1974,you havetherightnotto disclosedetailsof'spent' convictions. However,becausewearea school andyouwill beworking in an environmentwith children and young peoplewe areallowedtoaskabouttheseoffences. TheRehabilitationof OffendersAct1974(Exceptions)Order1975(as amended)setsoutdetailsof all jobstowhich thisappliesand thejobyou haveapplied for isincluded in thatlist.
Please givedetailsof ALL convictions,cautions,bindovers, reprimands, orwarnings(whetherspentornot).
CRIMINAL RECORD BUREAU
The Criminal Records Bureau is an executive agency of the Home Office and helps employers check records which were previously held by the police, the Department of Health and the Department for Children, Schools and Families. Different levels of disclosure can be provided, according to the type of work applied for.
The job for which you have applied will necessitate an Enhanced Disclosure. These are for positions with a greater degree of contact with children or certain vulnerable adults, like social workers and teachers, for example. They contain all the information given on a Standard Disclosure plus relevant non-conviction information held at local levels.
Have you ever been subject to any sort of investigation by an employer?
YES / NO
If you haveanswered 'yes'tothisquestion,pleasegivedetailson aseparatesheet. Pleasesupplydetailsof activitiesinvolving contactwith children and vulnerableadults outsidethe workenvironment(e.g. sportscoach,scoutleader,etc.). Pleasecontinueon aseparatesheetif necessary.
DECLARATION
I agree,ifI amselected forthisappointment,toan application beingmadetotheDisclosure and Barring Service (DBS)for anEnhanced and Barred Disclosureconcerning myself.I alsoconsenttoACScarrying outotherappropriatecheckswith theDBS if itsowishes.
Name (please print)
Signature / Date
Pleaseuse the extra space below to provide any additional details that you did not have space for whilst filling out the form.

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