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eyps application form 2012

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					                                                                                                              V3

EARLY YEARS PROFESSIONAL STATUS

CANDIDATE DATA SHEET
Please complete ALL sections of this application form and return it to CETAD, Lancaster
University, Bailrigg, Lancaster, LA1 4ZA.

1. CANDIDATE DETAILS (* denotes required information)
Forename(s)*
Surname*
Previous Surname
(if applicable)
Address*



Postcode*
Home Telephone*
Work Telephone
Mobile
Email*
Date of Birth*
NI Number*
Local Authority of
candidate’s employer**
Would you be happy to be contacted for feedback about EYPS?                                                   Yes             No
As part of CWDC’s on-going work, we are working with local authorities to
help support individuals once they have achieved EYPS. To help your
local authority deliver this support we can share your contact details with
them, but will only do so with your express permission. There is no
obligation on you to allow us to share your personal information with any
local authority.

Do you give permission to CWDC to share your contact details with your Yes                                                    No
local authority for the purpose of providing support to Early Years
Professionals?

Have you previously registered on an EYPS programme with another
training provider?                                               Yes                                                          No

If yes, please provide further details (e.g. provider’s name, date and pathway attended and the
reason for leaving)




** The candidate’s local authority if on the Graduate Entry Pathway




EYPS is sponsored by the Children’s Workforce Development Council     CETAD is a member of the EYP Northern Alliance led by
2. QUALIFICATIONS
Highest level of qualification*
Levels:      1            2              3           4             5             6          7   8
Year this qualification was achieved*

Highest qualification subject*

Highest relevant qualification level*
Levels:      1           2            3              4             5             6          7   8
Year this qualification was achieved*

Highest relevant qualification subject*


3. EMPLOYER DETAILS – If you are unemployed please leave blank and complete the
                                  additional information section
                             Daycare setting                           Sessional care setting
                             Children’s centre                         Childminder network
Organisation type*
                             Local authority                           Nursery school
                             Not employed
                             Private                                   Voluntary
Organisation sector*         Independent                               Maintained
                             N/A
Will you be funding your own studies/programme?               Yes              No
Organisation name
Contact name
Address


Postcode
Work Telephone
Email



Mentor Details (where applicable or leave blank)

Mentor name

Address

Postcode

Work Telephone                                            Work Email

Where did you hear about EYPS?
Advert                                                         CETAD Mailshot
Press Release *                                                National Mailshot
Poster                                                         Recommendation *
Other *                                   * please specify
4. EQUAL OPPORTUNITIES
To encourage fuller representation across the children's workforce, CWDC wishes to collect the
following equality information. These questions are optional. The information will be stored
securely and used to monitor the take up of training and employment opportunities by under
represented groups. No personal information entered within this section will be shared with any
third party.

Gender*                        Male             Female

Ethnicity                      White                                    Mixed race
                               Asian / Asian British                    Black / Black British
                               Chinese / Chinese British                Prefer not to say
                               Other please enter here……………………………………………...

Sexual orientation             Hetrosexual                              Gay/Lesbian
                               Bisexual                                 Celibate
                               Prefer not to say

Country of birth

Registered disabled            Yes***                  No

***If yes, please give a description your disability in the box below




FAITH
None                                                   Jewish

Prefer not to say                                      Baha'i

Christian                                              Jainist

Islamic                                                Shinto

Hindu                                                  Cao Dai

Chinese traditional                                    Zoroastrianist

Buddhist                                               Tenrikyo

Primal-indigenous                                      Pagan

African traditional                                    Unitarian-Universalism

Sikh                                                   Rastafarianist

Juche                                                  Scientology

Spiritism
5. SELF ASSESSMENT
This questionnaire is to help potential EYP candidates that are working in early years identify the most
appropriate pathway to achieve EYP Status. Think about the work you do within your setting and tick the
box that best fits your own situation.
                                                                                                     YES              NO
REQUIREMENTS
A. I do not have a criminal background that might prevent me from working with
children, or as an EYP, and have not previously been excluded (disqualified) from
working with children
B. I hold a degree or another graduate qualification(s)

C. I can provide evidence to show that I have achieved GCSEs at grade C or above
(or recognised equivalents) in English and Mathematics
D. I can read effectively and am able to communicate clearly and accurately in
standard English

                                                                                                Frequency
Experience
                                                                                   1.Often      2.Sometimes          3.Never
I work with babies from 0-20 months old
I work with toddlers from 16-36 months old
I work with young children from 30 and 60 months old
I guide the work of other practitioners
I know and understand the implications of Every Child Matters for
babies, toddlers and young children
I know and understand the implications of the EYFS for children 3-5
years
I know and understand the implications of EYFS for children 0-3 years
I am involved in leading and managing delivery of the EYFS within my
setting
I am involved in monitoring the work of other practitioners
I influence the work of other practitioners
I give feedback to other practitioners about effective practice in
delivery of the EYFS for 0-60 months
I work with other professionals beyond the setting in my work
I use literacy, numeracy and ICT skills in my work
I work collaboratively with other adults in my setting
I understand how to assess children’s progress and show others how
to do this
I work in partnership with parents / carers to improve outcomes for
children
I support other practitioners to work in partnership with parents / carers
to improve outcomes for children

Identifying your pathway:    This form provides an initial indication of pathway that may be most suitable for you

Graduate Practitioner         I meet all the requirements and through my experience have most ticks in column 1
                              (Often) or 2 (Sometimes) and few ticks in column 3 (Never)

Undergraduate Practitioner    I have a Foundation Degree in Early Years and through my experience I have most ticks
                              in column 1 (Often) or 2 (Sometimes) and few ticks in column 3 (Never) or I have an
                              unrelated Degree and little experience and am employed in the Early Years sector
Graduate Entry                If you are unemployed you may have most ticks, or all, in column 3 and will be applying
                              for the Graduate Entry Pathway
6. SUPPORTING STATEMENT
To support your application, please provide details below of your previous relevant early years
experiences (you may wish to attach a CV), or if you are unemployed and applying for the
Graduate Entry Pathway give some background information of your past work experience and
reasons for applying to be an EYP.
7. REQUEST FOR REFEREE DETAILS
Please provide the details of two referees who we can contact for a reference:

Who can act as a referee for you?
  Graduate Practitioner & Undergraduate Practitioner Pathways
  A referee is providing a both a character and professional reference for you and confirming your
  suitability for a career in working with children. They need to know you well but in a
  professional capacity.

  One of your referees must be your current employer.

  Examples of appropriate referees are:

         Current employer (required)
         Previous employer
         School Teacher / Head Teacher
         College or University Principal / Tutor / Lecturer
         Manager or Supervisor from work experience
         Manager of Supervisor from voluntary work


  Graduate Entry Pathway
  A referee is providing a character reference for you and confirming your suitability for a career in
  working with children. They need to know you well but in a professional capacity.

  Examples of appropriate referees are:

         Current employer
         Previous employer
         School Teacher / Head Teacher
         College or University Principal / Tutor / Lecturer
         Manager or Supervisor from work experience
         Manager of Supervisor from voluntary work


  For all pathways
  The following are examples of referees that would not be appropriate:
      Family
      Personal friends
Referee One

Name:


Post/Occupation/Relationship of referee:



Address (including post code):




Postcode:



Telephone:


Email:




Referee Two

Name:


Post/Occupation/Relationship of referee:



Address (including post code):




Postcode:



Telephone:


Email:
8. CRB DECLARATION
I confirm that I have no criminal background that might prevent me from working with children, and
have never been excluded for any reason from working with children.



Signature: ................................................................................................................


Date:            ................................................................................................................


                                           END OF APPLICATION FORM
                Please return to CETAD, Lancaster University, Bailrigg, Lancaster, LA1 4ZA.




For Office Use Only. EYPS Details

EYPS pathway
                                       Graduate Practitioner

                                       Undergraduate Practitioner

                                       Undergraduate Practitioner with BA top up

                                       Graduate Entry

Invite to interview?                                           Interview date:

Comments




Entered by                                                     Date                                EYPS ID

				
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