Application Form for Teaching Staff Role

Role

Application for the post of:* School Name* Where did you see the post advertised?

Personal Details

Title* First name(s)* Surname* Preferred Name Email* Home telephone number Mobile telephone number* Address (line 1)* Address (line 2) Town / City* Postcode* N.I Number* DCSF Number

Current or Most Recent Employment

Name of LA/ Academy* Name and address of school or establishment (inc. telephone number)* Position held (please state if this is permanent/temporary/acting/supply)* Date of appointment to school (dd/mm/yyyy)* To position (if different dd/mm/yy)

Type of appointment (full/part time)*Full timePart time

Date free to take up appointment (dd/mm/yy)* Second subject offered Age range of school*

Salary/Allowance details:

Current Scale (eg TMS, Leadership)* Actual Salary* Current Point Allowances

For Leadership Scales also complete

School Group ISR

Superannuation:

Please give details of Election to Opt Out where applicable

Previous Employment

Start with your most recent job. Teaching practise should only be included where this application is for your first
teaching job. You should include all paid employment, voluntary work, periods of unemployment and time spent
out of employment whilst undertaking caring responsibilities since leaving school, college or university. You may
be asked to explain gaps.

Previous Employment*


Name of school Or Local Authority
No of hours
Age range of school
Number on roll
Position held and salary point
Commenced
Completed

We reserve the right to approach any of the previous employers listed in this section to confirm the details you have supplied.

Other Employers

You should include all paid employment, voluntary work, periods of unemployment and time spent
out of employment whilst undertaking caring responsibilities since leaving school, college or university. You may
be asked to explain gaps.

Other Employment*


Name and address of employer
No of hours
Position held
Commenced
Completed

Education And Qualifications

Please give details of your education and any qualifications obtained. This should include any qualifications which you are studying for now. You will be required to prove you have obtained the qualifications you have listed.

*


Secondary school attended
Examinations in which successful subjects
Level
Grade
Year obtained
University or College attended (with dates)
F/T or P/T
Degrees obtained (with subjects
Pass/Hons
Class or Division
Year obtained

Teacher Training And Other Professional Qualifications


College or Department of Education Attended (with dates)
F/T or P/T
Qualifications obtained
Year obtained

Additional Qualifications

e.g. swimming awards, music certificates, coaching awards etc...

In Service Courses*


In service courses
Date
Venue

Supporting Statement

Other Details

Do you need a work permit to work in the UK?*YesNo

If yes, please give the date that your current work permit expires (dd/mm/yy):

(A copy of the permit will be required for successful candidates)

Please upload copy of permit (if applicable) and/or any other evidence relating to this application No file chosen

Certain Restrictions

Are you closely related to any person employed in the School or Governing Body? If so, please indicate the name and position of the person in question.

Criminal Convictions

This appointment is excluded from the Rehabilitation of Offenders Act 1974. Applications must declare any convictions which for other purposes are “Spent” and in the event of employment, failure to disclose such convictions could result in dismissal or disciplinary action by the School. This includes the Childcare Disqualification Requirements (DfE).
I will provide the information requested on a questionnaire to be sent to me at the time of shortlisting and understand that the provisionally selected candidate for such posts will be required to apply for a Criminal Records Bureau Disclosure at the appropriate level and childcare disqualification requirements. Any information will be treated confidentially.

Signature*Tick this box to confirm all details entered above are correct

Confirm date of this application

References

Name by which you were known to your referee(s) if different from now

(A) Referee Details

Name* Position* Address* Postcode* Email* Telephone Number*

(B) Referee Details

Name Position Address Postcode Email Telephone Number

References may be requested prior to interview, for those candidates shortlisted.

May we contact your present employer if you are shortlisted?*YesNo

If you have indicated NO above, please note that references will be required if you are the preferred candidate after interview.

Declaration

I declare that the information I have provided is a complete and true statement.

I understand that any offer of appointment and subsequent employment is conditional on this declaration and if my application is incomplete, untrue or inaccurate, then the School will be entitled to withdraw any offer of appointment or terminate any contract of employment.

I will not approach any employee of the School in order to advance my appointment, as I understand this will disqualify me from consideration, other than if the advertisement invites me to contact a named individual.

I understand that the information provided on this application form will be used to form the basis of a personnel file and a computerised personnel record should an offer of appointment be made. Further details about data protection will follow with any contract of employment.

Please confirm your name*