Teacher Application interactive 2 by Fp05N61


                                         Aldridge School                    Appointment of Teachers
An equal opportunity employer
                                        A Science College
When completing this form all entries should be typed or written in black ink or ball point pen to
facilitate photocopying. You are advised before doing so to read the notes on page 3 of this form and
any further particulars for the post which have been supplied.

     Aldridge School A Science College is committed to safeguarding and
   promoting the welfare of children and young people and expect all staff,
            volunteers and students to share in this commitment

                     All appointments are subject to satisfactory CRB,
                               medical and reference checks

 Post:            Closing Date:

1. Personal Details (Please use block capitals)
                                                       First Name (s):
Title (Mr/Mrs/Ms/Dr.)
                                                       Home Telephone:
                                                       Mobile Telephone:
                                                       School Telephone:
Previous Name(s):
                                                       E-Mail Address
                                                       National Insurance No:

Post Code                                              D.F.E Reference No:

GTC Registration Number:                               Date of Recognition
                                                       as Qualified Teacher:

2. Education After Age 16
                                                                      Month/Year           Full Time or
                                  Name of Establishment
                                                                   From        To           Part Time
a) School & Address
b) University
c) College of Education
d) Other Establishment

3. Qualifications
a) First Degree Univ/College      Degree        Pass/Hons     CI/Div         Subject(s)     Date
                                                                             etc.           awarded

b) First           Univ/College          Special areas of study, including age range

c) Other qualifications (A levels, diplomas                  Give full details
   or certificates, further degrees including
   membership of professional

4. Present Appointment
Post held:                                          Date of appointment:

                                                    Present Salary:
                                                    CPS Point No:

                                                    Earliest Date on which you could take up
Approx. no. of pupils:                              appointment:

Local Education Authority:

5. Previous Teaching Appointments (in chronological order beginning with the first):
Title of Post Full Time School/Establishment Name of LEA       Sex &         Age       Period of
                  or      (state age range)     or other       No. of       range       service
              Proportion                       employer       pupils on    taught    (month/year)
                of Full                                         roll      by you
                 Time                                                                From       To

6. Non Teaching Appointments
(Occupation/employment after age 16, including Military Service, not stated elsewhere on this form).
Enter in date order:
Nature           of     Salary          Name & Address        Full-time or Pat-         Dates
Occupation                                 of Employer               time           (give month &
                                                                                 From           To

7. In Service Courses Attended During Last Five Years

8. Health Record (State nature/duration of any illness or medical condition during past five years)

9. Absence from Work (State all absences from work and the reasons for them for the past 2 years)

10. Data Protection Act
The information collected in this form will be used and stored in compliance with the Data Protection
Act 1998. The information is being collected by the Data Manager for the purpose of administering the
employment and training of employees and the Governing Body of Aldridge School. The information
may be disclosed, as appropriate, within the Education Service to the Governors’ Occupational Health
Adviser, to the General Teaching Council, to the Teachers’ Pensions Agency, to the Department of
Education and Skills, to the Department of Work and pensions, to the West Midlands Metropolitan
authorities Pensions Fund, pension providers (including providers of AVCs) and to relevant statutory

You should also note that because we have a duty to protect the public funds we handle we might
need to use the information you have provided on this form to prevent and detect fraud. We may also
share this information for the same purposes with other organisations which handle public funds.

11. Disability
The Disability Discrimination Act 1995 requires an employer to make “Reasonable Adjustments” to
working conditions in order to enable disabled applicants to have equal access to employment
opportunities. Completion of this section is optional. The information disclosed will only be used to
enable a fair decision to be made and will not be used to discount applicants.

Do you have such a disability?     Yes            No

Please indicate if you have any special requirements to enable you to attend for interview.

12. Disclosure of Relationship
A candidate for any post within Aldridge School who knows that he/she is related to any Governor or
employee of the school, must disclose the relationship. A candidate who fails to disclose a relationship
is disqualified for appointment and if appointed is liable to dismissal without notice.

Are you related to any Governor or Employee of the School              Yes            No

If yes, who?

13. Asylum and Immigration Act 1996
It is a criminal offence to employ persons whose immigration status prevents them from working in
this country. The Act does not affect citizens of the UK, Ireland, European Economic area and the
Commonwealth, provided they have a right of abode in the UK. Therefore, before you commence
working you must provide evidence to demonstrate your right to be in or work in the United Kingdom.
If you are appointed to a post in the School you will receive further guidance.

Have you the right to work in the United Kingdom? Yes           No

Is this subject to a Work Permit? Yes     No

14. Letter of Application
In support of your application you are invited to attach a letter stating your reasons for applying for
this post and including any information which you consider relevant to this application.

                                       Notes for Applicants
Applicants are requested to read carefully the following notes and any further particulars for the post
before signing the declaration.

Notification of Result
It is the policy of Aldridge School, that, in order to keep administrative costs to a minimum, notice of
the result of an application shall not be sent to an unsuccessful candidate who is not called for
interview for any post. If, therefore, you do not hear within 6 weeks of the closing date for
applications for this post, you should normally assume that an appointment has been made.
15. Other Information

Do you hold a valid driving licence?                YES        NO                If yes, specify type

16. References
Please give names, addresses and status of two referees who have given permission for their names to
be used and to whom the School may refer as to your suitability for the post. If possible at least one
reference should be from your present employer.



17. Superannuation

a) Are you in receipt of a pension? YES     NO
Local Government       Teachers    Other Superannuation Fund

b) Have you elected to contribute, in respect of part-time Teaching Service?
YES    NO     Date:

18. Declaration
Having read the contents of this form, I hereby apply for the post named on the top of Page 1 of this
form, in accordance with the conditions stated therein. I declare that information I have given on this
form is correct and I understand that failure to complete the form fully and accurately could result in
an incorrect assessment of salary.

Signature        .......................................................................... Date

On completion this form should be returned to the Headteacher unless otherwise stated in the
advertisement. If you wish you may attach copies of the testimonials. If you want to e-mail your
completed application please send this and other attachments to applications@aldridge.walsall.sch.uk


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