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References - Please give the names and addresses of two people to

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					                               Medlock Primary School

                            APPLICATION FORM

Post: Assistant HeadTeacher at Medlock Primary School
Data Protection Notice: INFORMATION OBTAINED MAY BE SHARED WITH THESE
OUTSIDE AGENCIES AS REQUIRED BY LAW: Manchester City Council, the Department for
Children, Schools and Families, and Ofsted.

An enhanced Criminal Records Bureau check is required for this post. Any offer of
employment is conditional until this check is completed.

This form, completed by the Candidate, must be returned to: Medlock Primary School,
Wadeson Rd, Manchester M13 9UJ.

The application should be supported by a letter of no more than 2,500 words.
_________________________________________________________________________
Surname:
_________________________________________________________________________
Other Names:
_________________________________________________________________________
Present Address:                                      Tel. No:




Daytime telephone number (if different):
_________________________________________________________________________
Education (from age 18, with dates and grades)



_________________________________________________________________________
Qualifications Awarding body, Date of Award, Level and Grade of Award (Please include
teaching qualification)



_________________________________________________________________________
In-Service Training - Brief Details of Courses, Dates
PRESENT APPOINTMENT

   From                  Institution                  Position Held




On what date would you be able to start: ______________________


                 PREVIOUS EXPERIENCE (Please list in date order)

       Full and part-time work or training (please clearly state which)
                Experience can be either paid or unpaid work.

   From     To          Institution       Position and Grade       Main Duties
References - Please give the names and addresses of two people to whom references can
be made. If you are at present employed, please include details of present employer.




.
_________________________________________________________________________


How soon after a job offer could you start? ______________________________________

_________________________________________________________________________

Are you disabled?                                   Yes             No

If 'Yes' are you registered disabled?               Yes             No

National Insurance number: …………………………………………………

Date of Birth: ………………………………………..

GTC Teacher Reference Number: …………………………………………………
_________________________________________________________________________


Please attach separate sheets to provide additional information in
support of your application. It is most important that you show how
you meet the Person Specification, addressing all of the points on it.



Declaration

I can confirm that to the best of my knowledge, the information I have provided in this
application is correct. I understand that if the information I have provided is false or
deliberately misleading, any offer of employment will be withdrawn, or if appointed, I will
be dismissed without further notice.


SIGNATURE: ..................................................   Date: ..............................

				
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Description: References - Please give the names and addresses of two people to