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DARTFORD GRAMMAR SCHOOL - DOC

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									                                   DARTFORD GRAMMAR SCHOOL
                                   West Hill, Dartford, Kent DA1 2HW
                                  Tel: 01322 223039 Fax: 01322 291426
                               e-mail: admin@dartfordgrammar.kent.sch.uk

APPLICATION FORM Post:                                                    Closing Date:

                          ******PLEASE PRINT CLEARLY IN BLACK INK******

Section 1        PERSONAL DETAILS
Surname                                       Forenames                        Preferred Title

Previous surname(s)                           DfES No      __/_____       GTC Full Registration Yes/No

Date of birth                                 National Insurance Number

Address


                                                         Post Code
Telephone       Home:                                    Work:
                Mobile:                                  Fax:
e-mail

Section 2      PRESENT TEACHING POST (if applicable)
Present Post (Title)                              Date Appointed
                                                  Point on Scale
                                                  Full/Part-time
Name of School
Address


                                                     Post Code
Type of School                            Age Range                            No on Roll
Boys/Girls/Mixed                          Age Range Taught
Subjects, Main & Subsidiary

Other Special Interests


Section 3        REFERENCES
                 One of these should be your present or most recent employer
Name                                                  Name

Capacity in which known                               Capacity in which known
Address                                               Address

                                                      Post Code
Post Code
Telephone                                             Telephone
Fax                                                   Fax
e-mail                                                e-mail
If your referees knew you by another name write that name in this space

                                                     1
Section 4      EDUCATION
                                                      Dates
Please enter names of                       From                   To                     Qualifications
schools/institutions

Secondary School, College,
Further Education



Higher Education




Further post graduate study




Section 5     CAREER HISTORY
              Please give details of ALL full and part-time work as well as particulars of ALL paid or
              unpaid employment or experience after the age of 18, e.g. commercial experience, raising
              family, youth work, voluntary work. Complete the columns starting from the present date.
              Please leave NO gaps.
    Dates       Employer, address            School            Age      Approx    Salary        F/T   Reason for
                School name & address,       County/           Range    School    Scale         P/T   leaving
                                             Foundation/                           Include
From     To     type of business activity                               Roll                     %
                                             indep                               Responsib-
                                                                                 ility points
M Y M Y




                                                           2
Section 6    IN-SERVICE TRAINING & DEVELOPMENT
             Give details of relevant courses and training undertaken in last five years
Dates and Duration Title of Course/Training incl.         Name of Provider           Qualification obtained
                      Home Study and Distance           e.g. LEA, College, etc              (if any)
                                Learning




Section 7    PERSONAL INTERESTS, OR ACTIVE INVOLVEMENT OUTSIDE WORK
             (e.g. Youth Leader)




Section 8     REHABILITATION OF OFFENDERS ACT 1974
              If you have no convictions, simply enter „NIL‟. If you have been convicted of a criminal
              offence, the details must be listed below, together with any pending criminal action or court
              hearings against you. Please see Notes for Applicants for guidance. In addition, the School
              will require the successful candidate to co-operate with the school who will be seeking to
              obtain an Enhanced Disclosure from the Criminal Records Bureau in relation to criminal and
              child protection matters.

  Date of conviction or                   Offence                                 Sentence
    pending hearing




                                                    3
Section 9      HEALTH AND MEDICAL HISTORY
Are you a registered disabled person?                                 YES / NO
If YES, please state Registration number
Have you suffered from any medical condition that has affected        YES / NO
(or might in the future affect) your performance as a teacher         Please give details on separate sheet.

How many days‟ absence from work have you had in the last two
years?
(Specify maternity related sickness separately)
For what reasons?



Section 10     APPLICANT STATEMENT
               Pick out those aspects of your experience or skills that are relevant to this post. Explain how
               your ability, skills and knowledge match those required for the appointment, where set out,
               in the person specification or job description. Remember to consider experience in previous
               employment and relevant experience outside of paid work, such as that gained at home, in
               the community or through voluntary / leisure / college activities.
               Give examples, where you can, in support of your application.




   Continue on separate sheet(s) if necessary, or alternatively, attach a separate letter of application.

                                                     4
 Section 11      DECLARATION
                   I understand that any employment, if offered, will be subject to the information on
                   this form being correct and I can confirm that no valid information has been wilfully
                   withheld.

 Please delete where applicable:
                   I am/am not related to any senior member of staff or governor
                   I am prepared to undergo a medical examination if required
                   I can produce the original documents of my qualifications




 Signature: ………………………………………………………                                    Date: ………………………………..


 If you are returning this application form by post, please sign and date. If returning by e-mail you will be
 asked to sign a copy of this document before any offer of employment is made.


 Please give any dates when you are not available for interview:………………………………………………




 (The post will be subject to the terms and conditions of the Dartford Grammar School contract)




Please indicate where you saw the advertisement for this position:         TES publication………………

                                                                           TES on-line……………………

                                                                           Kent-Teach……………………

                                                                           Other (please state)…………...




                                                                                                  (See pages overleaf)
                                                       5
ASYLUM AND IMMIGRATION ACT 1996

In accordance with the Asylum and Immigration Act 1996, the Governing Body will require new members of
staff to provide documentary evidence that they are legally entitled to live and work in the United Kingdom.
Upon taking a post candidates should provide one of the official documents listed in the Notes for Applicants.

                                       NOTES FOR APPLICANTS

 REHABILITATION OF OFFENDERS ACT 1974

 Details of spent convictions – information for applicants
 You must declare all convictions that you have, including motoring offences and all convictions that have
 become “spent”.

 ASYLUM AND IMMIGRATION ACT 1996

     1. A document from a previous employer, the Inland Revenue, the Benefits Agency, the
         Contributions Agency or the Employment Service (or their Northern Ireland equivalents), showing
         your name and National Insurance number. This could be a P45, a pay slip, a P60, a National
         Insurance card or a letter issued by one of the Government bodies concerned.
     2. A passport describing you as a British citizen or having the right of abode in or an entitlement to
         readmission to the United Kingdom.
     3. A passport containing a Certificate of Entitlement issued by or on behalf of the Government of the
         United Kingdom certifying that you have the right of abode in the United Kingdom.
     4. A certificate of registration or naturalization as a British citizen.
     5. A birth certificate issued in the United Kingdom or in the Republic of Ireland.
     6. A passport or national identity card issued by a State which is a party to the European Economic
         Area Agreement and which describes you as a national of that State.
     7. A passport or other travel document endorsed to show that you are exempt from immigration
         control, have indefinite leave to enter, or remain in, the United Kingdom or have no time limit on
         your stay; or a letter issued by the Home Office confirming you have such status.
     8. A passport or other travel document endorsed to show that you have current leave to enter or
         remain in the United Kingdom and are not precluded from taking the employment in question; or a
         letter issued by the Home Office confirming that this is the case.
     9. A United Kingdom residence permit issued to you as a national of a State which is a party to the
         European Economic Area Agreement.
     10. A passport or other travel document endorsed to show that you have a current right of residence in
         the United Kingdom as a family member or a named national of a State which is a party to the
         European Economic Area Agreement and who is resident in the United Kingdom.
     11. A letter issued by the Immigration and Nationality Directorate of the Home Office indicating that
         you are a British citizen or have permission to take employment.
     12. A work permit or other approval to take employment issued by Work Permits (UK) or in Northern
         Ireland, by the Training and Employment Agency.
     13. A passport describing you as a British Dependent Territories citizen and which indicates that the
         status derives from a connection with Gibraltar.




                                                     6
                              RECRUITMENT MONITORING INFORMATION


     Post title:                                        Dartford Grammar School

     Surname:                                           First names (s):

     Date of birth:

                                        ____________________________

     Completion of this section will help us fulfil our general duty under the Race Relations (Amendment) Act
     2000 to eliminate unlawful discrimination, to promote equality of opportunity and promote good relations
     between people of different racial groups, and our specific duty under the Act to monitor, by reference to
     racial group, applicants for employment and staff in post. The information provided will be used for
     monitoring and statistical purposes only and this section will be detached from your application prior to
     shortlisting.
                                        _____________________________

The categories below are in line with the 2001 census

A. ETHNIC ORIGIN
Please tick one box only, indicating the category that best describes your ethnic origin.

1.       White                                               4.   Asian or Asian British
           British                                                Bangladeshi                   
            Irish                                                 Indian                        
           Any other white background                             Pakistani                     
           Please specify                                          Any other Asian background    

2.       Black or Black British                             5.    Chinese
             African                                               Chinese                      
             Caribbean                     
             Any other Black background    

3.       Mixed                                              6.    Other ethnic group
            White & Asian                                          Any other ethnic group       
            White & Black African                                  Please specify
            White & Black Caribbean        
            Any other Mixed background     
            Please specify


B.       GENDER
            Male                           
            Female                         

                      The information contained on this form will be held on a computer file




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