EYPS app form by Na9a2u

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									Faculty of Development and Society

APPLICATION FORM FOR EARLY YEARS PROFESSIONAL STATUS
Please complete this form in BLOCK CAPITALS and return to EYPS administration, Stephen
Coates, Sheffield Hallam University, 10101 Arundel Building, City Campus, Sheffield, S1 2NE
or s.a.coates@shu.ac.uk


I wish to apply for the following EYPS route:

Graduate Practitioner Pathway (6 months, Part time)

Undergraduate Practitioner Pathway (12 months, Part time)

Graduate Entry Pathway (12 months, Full time)

Undergraduate Entry Pathway (12 months, Full time)

*For more information about the pathways please visit our website: www.shu.ac.uk/ad/eyps



   1. PERSONAL DETAILS
Surname                                                                       Title
                                                                              Mrs/Miss/Mr/Ms/Other

Surname on 16th Birthday


Forename (s)


Correspondence address




Postcode

Home Telephone

Work Telephone

Mobile Telephone

Email address

National Insurance number


Date of Birth                  Day                     Month                   Year
Faculty of Development and Society


    2. QUALIFICATIONS
Please include details of GCSE, degree and other professional qualifications. You will be required to
produce copies of your certificates upon enrolment of the course.

Qualification                  Subject                         Date         Grade          Awarding
                                                                                           institution

GCSE/GCSE equivalent           MATHS


GCSE/GCSE equivalent           ENGLISH/ENGLISH
                               LITERATURE

DEGREE




    3. ENGLISH LANGUAGE
Is English your first language?                          Yes       No

If English is not your first language, was English the   Yes       No*
language of instruction for your first degree?

*If you answered no to the above please complete the following

Name of English             Awarding                           Date qualification          Result
language qualification      body/college/institution           obtained/date taking
                                                               qualification
Faculty of Development and Society


Have you previously registered on an EYPS programme with another training
                                                                                                                Yes          No
provider?
If yes, please provide further details (e.g. provider’s name, date and pathway attended and the reason for
leaving)


Do you have any professional status? (Eg QTS)                                      Yes                  No
If yes please specify........................................................................




     4. NATIONALITY AND RESIDENCE DETAILS
Country of birth (the country where you were born)

Nationality (the country for which you are entitled to
hold a passport)

Country of domicile (the country you live in)

Do you have the right to study in the UK for the                               Yes              No
duration of your pathway?

Do you have the right to work in the UK for the                                Yes              No
duration of your pathway?




     5. EMPLOYER DETAILS – If you are unemployed please leave blank and go to question 6
                            Daycare setting                                      Sessional care setting
                            Children’s centre                                    Childminder network
Organisation type           Local authority                                      Nursery school
                            Not employed


                            Private                                              Voluntary
Organisation                Independent                                          Maintained
sector                      N/A


Area of                     Please identify if your setting is situated in an area designated as one of the 30% most
disadvantage                disadvantaged? Yes            No         Unsure
Who is expected to pay your fees?                                  CWDC                              Other
                                                                   If other please specify...........................................
Faculty of Development and Society

Organisation
name
Contact name at
organisation


Address




Postcode
Work Telephone
Email



Mentor Details (where applicable or leave blank)

Mentor name

Address

Postcode

Work Telephone                                              Work Email



Please give a brief description of your current role and responsibilities.
Faculty of Development and Society


    6. WORK HISTORY
        Please give details of your work experience and employment starting with the most recent.
        Please ensure you explain any gaps in your work history.



Job Title and brief description of   Name and address of employer          Start date      End date
your role
Faculty of Development and Society


    7. 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




Registered disabled               Yes*                       No



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




Do you have any other support needs?               Yes*                     No
                                                   * Please give details:


Faith/Religion
Faculty of Development and Society


8. SUPPORTING STATEMENT
To support your application, please provide details below of your previous relevant early years
experiences including responsibilities in relation to practice and leadership and experience across the
age ranges (0-20 months, 16-36 months and 30-60 months) and your reasons for wanting to undertake
EYPS or if you are not employed in the early years sector and are applying for the Graduate Entry
Pathway give some background information of your past work experience and reasons for applying to
be an EYP.
Faculty of Development and Society
Where did you hear about EYPS?
Advert                                                           SHU Mailshot
Press Release *                                                  National Mailshot
Poster                                                           Recommendation *
Other *                                    * please specify ____________________________________




    8. DECLARATION
I declare that the information on this form is correct. I understand that any offer of a place is subject to
my acceptance of the University's terms and conditions. I accept that if I do not fully comply with these
requirements Sheffield Hallam University reserves the right to cancel my application.

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.

I agree that Sheffield Hallam University may record and process the information contained in this form for
statistical and administrative reasons in accordance with the Data Protection Act 1998.



Applicant’s Signature:                                               Date:

If you are submitting this form electronically, we will ask you to sign this form at a later date.
Faculty of Development and Society
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
Faculty of Development and Society
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 do not meet requirement C but have an unrelated Degree and little experience and
                                am employed in the Early Years sector or 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)

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

Undergraduate Entry             If you are on an Early Childhood Studies degree you need to apply for the
                                Undergraduate Entry pathway.
Faculty of Development and Society

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 and Undergraduate 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
Faculty of Development and Society

 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:
Faculty of Development and Society

SETTING APPROVAL FORM (to be completed by the manager/owner of
the setting) if applying for the GPP or UPP

Manager/owner name

Setting name and address



How long has the candidate been employed at the
setting?

Does the candidate hold current CRB clearance                        Yes                 No

Does the prospective candidate meet physical and                     Yes                 No
mental fitness to work as an EYP?

In your opinion is the prospective candidate already                 Yes                 No
operating at the level of the EYPS standards?

Does the prospective candidate have your support to                  Yes                 No
undertake the GPP or UPP Route?

Please add any additional comments about this prospective candidate’s application for Early Years Professional
Status




Signature                                               Date
Faculty of Development and Society

CHECKLIST
Please ensure you have included all the necessary information to allow your application
to proceed smoothly.



   Complete SHU Application form including signed declaration.

   Reference details

   Setting Approval Form (to be completed by your manager if applying for the GPP or UPP)

   Self-Assessment Diagnostic




For Office Use Only. EYPS Details

EYPS pathway           Graduate Practitioner pathway

                       Undergraduate Practitioner pathway

                       Undergraduate Entry pathway

                       Graduate Entry pathway

Entered by                                  Date                   EYPS ID

Invite to interview?                        Interview date:

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