Application for Employment Teaching Form 2012 Protected by Tb406M3


									                                    Application for Employment (Teaching)

                    Post Applied for

Personal Details

            Title (Mr/Mrs/Ms/Miss)

                First Names (in full)


                      Maiden Name


                           Post Code

              Home Phone Number

             Mobile Phone Number

              Work Phone Number

                      Email Address

                      Marital Status

                       Date of Birth



       National Insurance Number

           DfEE Reference number
 Do you have any special requirements of which we should be aware of in an arranging an interview?

Current Employment (if employed)
                  Post Held/Job Title
      (if part time include details of
             proportion of full time)
          School/College/Employer                                                             Number of Pupils

  Subjects, Age Groups Taught and
             Other Responsibilities

                              Salary                                    Incremental Point
           Notice Required and/or
       Date Available if Appointed
Employment History
 If you have any gaps in your employment record please explain:

 Please list all past employment in the table below starting with your most recent post first.
                        Length of                                                  Age
   Employer and                      From        To       Post, Responsibilities               Reason for Leaving
                         Service                                                  Range
Education & Qualifications
    Secondary School         From      To          Qualifications Obtained, detailing Subjects and Grades

                                                          Pass/         Class/    Date             Subject
    College/University       From      To      Degree
                                                         Honours         Div     Obtained   Main     Subsidiary

    H.E. Institution

 Membership of Professional Institutions etc. gained by Examinations,
 other Teaching Qualifications e.g. TDLB, City & Guilds
Supporting Information
You are invited to set out further information below in support of your application.
Please continue on a separate sheet if necessary:
Names, addresses and status of two referees (one of whom must be your present employer or last employer if
presently not employed). References will be taken up prior to interview.
Name:                                                         Name:

Address:                                                      Address:

Office Telephone:                                             Office Telephone:

Email:                                                        Email:

Employment Checks

Rehabilitation of Offenders Act 1974 (exemptions) Order 1975

Because teaching, with the privileged access it gives to children, is an exempted occupation under the rehabilitation of
Offenders act 1975 (exemption) order 1974 we shall, through the Criminal Records Bureau, make checks to establish any
criminal record upon offer of appointment and your signature at the end of this form will be regarded as signifying your
agreement that this may be done. We have deemed that all personnel follow this procedure. You should indicate whether
you have any convictions as follows:

Have you ever been convicted of a criminal offence?             YES/NO

If yes please give details of the conviction and the date(s) on a separate sheet and attach it to this form. Failure to declare
any such conviction, or false declaration, is liable to result in immediate dismissal.

Alton Convent School is committed to safeguarding and promoting the welfare of children. Applicants must be willing
to undergo child protection screening appropriate to the post, including checks with past employers and the Criminal
Records Bureau.

Please state whether, to the best of your knowledge, you are related to a governor or any member of staff at Alton
Convent School:

I understand that if I am appointed personal information about me will be maintained in computerised and
manual systems for personnel/employee administrative purposes including analysis for management purposes and
statutory returns, subject to the data protection act.

The information I have provided on this form is correct and complete to the best of my knowledge and belief.

Signature of candidate:


Please return to : Mr G Maher, Alton Convent School, Anstey Lane, Alton, Hampshire GU34 2NG

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