HERNE BAY HIGH SCHOOL - DOC

							                               HERNE BAY HIGH
                       Specialist School & Sports College

                                    APPLICATION FORM
                                         (Non-Teaching)


POST

Surname:                           Forename(s):                 Previous Surname:



Miss/Mrs/Ms/Mr                     National Insurance No:       Date of Change:




Date of Birth:

Permanent Address:                                Address for Correspondence (if different):




                                                  Telephone Number:
Telephone Number:


Mobile Number


Email Address:



DISABILITY


Do you have a disability?                                                    YES / NO


Are you a registered disabled person?                                        YES / NO


If so state Registration number:

What is the nature of your disability?
PRESENT POST


Date of Appointment:


Post Held:


Specific Responsibilities:




Current Salary:

PREVIOUS EMPLOYMENT

Please list all previous employment in chronological order.
State whether full or part-time.
       Dates
                             Employers Name and Address       Position Held
From           To
EDUCATION AND TRAINING
     Dates             Name of School/           Subject and             Date & Grade
  From     To         College/University         Qualification             of Award




REFERENCES

Please give the names of two referees who can be consulted regarding your suitability for
the post. One of the referees should be your present or most recent employer. References
will be taken up before an offer of appointment is made. These will be requested prior to
interviews.

Name and Address (incl post code):            Name and Address (incl post code):




Position Held:                                Position Held:


Telephone Number/email address:               Telephone Number/email address:
REHABILITATION OF OFFENDERS ACT 1974

Because of the nature of the work for which you are applying, this post is exempt from the
provisions of the Rehabilitation of Offenders Act 1974 (Amendment Order 1986). You are
therefore required to disclose details of any spent or unspent cautions or convictions.
Disclosure of an offence does not necessarily bar you from employment. Please attach
details on a separate sheet.

A Criminal Disclosure Check will be carried out if you are selected for this post.


SIGNATURE:



Are you related to any member of the Governing Body:                                 YES / NO


If so, please give details. Failure to do so may lead to disqualification.




DECLARATION

I certify that to the best of my belief all the questions have been answered accurately and
fully.

I understand that any false information or omissions deliberately meant to mislead could
result in dismissal.


SIGNATURE:                                                   DATE: