OHS app teaching post 20101202

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					                            ORCHARD HOUSE SCHOOL
                     16 Newton Grove, London, W4 1LB     Tel: 020 8742 8544   e-mail: info@orchardhs.org.uk

                              Application for a Teaching Post
Employment history, education and academic qualifications as well as personal details which are already clear from
any CV enclosed with this form may be omitted below
Post Applied for:                                                 Advertised in & date:
Surname:                                                     Forenames:
Title:                                                       Previous surname:

Present address (including postcode):

Tel no.:                                               e-mail:

DfE No. (if any):

Date when free to start:

In the past two years, have you been absent from work for any period exceeding one                            Yes / No
                                                                                                     If ‘yes’, please provide
week?                                                                                              details on a separate sheet

Name and type of current school:
Present post:                                                         Full time/Part time
Age of children in the class:                                  Number of children in class:

                                 a) to school:
Date of appointment:
                                 a) to present post (if different):

Full or part time:

Present salary (basic and any allowances/weightings)
Please supply in your CV or on a separate page or in an accompanying letter details of previous teaching
experience or work with children

Secondary school(s) attended (with dates)

“A” Levels or equivalent passes + grades

University and/or College:

                                                                          Full/Part Time      From/To:

                                                                          Full/Part Time      From/To:

                                                                          Full/Part Time      From/To:

Principal subject areas:

Indicate the National Curriculum stages you are specifically trained to
                                                                                         EYFS      KS1         KS2       KS3
References will be taken up only if you are short listed for the post. The main reference will be sought
from your present employer or, if new to the profession, your college. You are requested to name two
additional referees unrelated to you in any way whatsoever. Unless you state otherwise following a first
interview we assume we have your permission to contact the referees.

Employer or College referee
Name:                                                                     Status:

Tel no.:                                             e-mail:
1 additional referee (Professional)
Name:                                                                     Status:

Tel no.:                                             e-mail:
2        additional referee (Friend, friend of family, someone who has known you > 10 years but NOT a relation)
Name:                                                                     Status:

Tel no.:                                             e-mail:

Please answer the two questions in this box by placing a circle around the answer that applies and
deleting the one that does not. If you have to answer ‘No’ to either question, please give full details on a
separate sheet in order that your suitability for the post may nonetheless be considered carefully.
Protection of children
In accordance with guidance by the Department for Education the school requires all new members of
staff to have been the subject of an enhanced disclosure (the check applicable to someone who is to be
working with children) by the Criminal Records Bureau. The school provides a form of application for the
disclosure upon offering an appointment to its staff. Can you confirm that you know of no matter likely to
be contained in such a disclosure? Yes No

The information I have given on this application form and any papers that accompany it is true
and complete.

Signed:                                                              Date:

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