Royal Grammar School by 9vaq65C


									                                        Royal Grammar School, Newcastle

                                        Application for support staff post

                      Details required under Safer Recruitment procedures

Name: _________________________________________________________________________

Position applied for: Director of IT Services

Where did you see this job advertised? __________________________________________________

If there is not enough space for you to answer any of the questions, please continue on a separate sheet.

Personal details

Surname:                                                     Forenames:


Home address:                                                Correspondence address (if different):

Post code:                                                   Post code:

Phone numbers: Day:                                          E-mail:

Are you on List 99, disqualified from work with              Note that this appointment is exempt from the
children?                                                    Rehabilitation of Offenders Act 1974. All
                                                             convictions, cautions and bind-overs must be
                                                             declared. If this applies, send details in a sealed
                                                             envelope marked “Confidential – for the attention of
                                                             the Headmaster”.
Are you related to, or have a close relationship, with
any employee or governor of the RGS?
Do you have a clean current driving licence?

Education and Qualifications

                                                  Dates           Qualifications obtained (including A   Date
                                                  attended        level grades / degree class(es)        obtained
Secondary school(s)

Further/Higher Education
Any other relevant qualifications / training

Employment history

Current employer:                                                                    Since?


Job title:

Brief description of responsibilities:

Reason for leaving / wishing to leave:

Notice period?                                      Current salary? [not mandatory]

Previous employers (most recent first). You must account for any gaps in your employment history.

Employer                                 Dates     Position held with brief description of responsibilities

Please give the names of two referees who can comment sensibly about your suitability for this post. (NB We
reserve the right to contact other people who know you and may be in a position to comment.)

Name:                                                     Name:

Address:                                                  Address:

Phone:                                                    Phone:

E-mail:                                                   E-mail:


Can we approach this referee prior to interview           Can we approach this referee prior to interview
Yes/No                                                    Yes/No

Signature: ___________________________________________                          Date: ___________________

Now please sign the declaration below (if you are applying electronically you will be asked to sign a
hard copy if offered the post).
I declare that all the information I have provided in respect of this application is full and correct at the time
of application and that I have not omitted anything that should be relevant to the appointment of someone
who will work with unsupervised access to children. I confirm that I am not on the DCSF List 99 or
otherwise disqualified from work with children. I further declare that I have no convictions, cautions, bind-
overs or other Orders of the Courts made against me.
Signed:                                          Date:

If you cannot sign such a declaration, you are not necessarily disbarred from applying and being offered at
post at The RGS. Please read the Information for Applicants carefully and, if in doubt, call the Bursar to
discuss the matter in the strictest confidence. If you wish to disclose any convictions, these should be set
down on a separate sheet and attached to the application in a sealed envelope marked ‘Private &
Confidential – for the attention of the Headmaster and Bursar only’.

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