APPLICATION FORM FOR THE POST OF TEACHER ST. ELIZABETH'S by courtneyanderson

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									                                                                                                         CONFIDENTIAL
                                             ST. ELIZABETH’S CENTRE
                                         CONGREGATION OF THE DAUGHTERS
                                                OF THE CROSS OF LIÈGE
                                             Much Hadham, Herts. SG10 6EW
                                         Tel: 01279 843451 Fax: 01279 844203

                                                    Registered Charity No. 1068661



                                                APPLICATION FORM

                                       FOR THE POST OF TEACHER
                                        ST. ELIZABETH’S SCHOOL
                          (Notes for the guidance of applicants are included and should
                                  be read carefully before completing the form)




1.     PERSONAL INFORMATION



       Surname: …………………………….                               Forenames: ………. ………………………………….

       Preferred title: Mr/Mrs/Miss/Ms/Other .……………………


       Postal Address                 …………………………………………
       (for correspondence):
                                      …………………………………………

                                      …………………………………………                                Post Code: ………………….

       Home Tel. No. ………………………………. Work Tel. No. …………………………………
                                                                (discretion will be used if we have to contact you at work)
       Mobile Tel No. ……………………………….

       Date recognised as qualified by DfES: ………………… ………………………………………..

       DfCSF/GTC Reference No: ……………….… National Insurance No: …………………….

       Do you require a permit to work in the U.K?                       Yes          No

       Do you hold a full current driving licence?                       Yes          No

       Do you have the Catholic Certificate in Religious Studies (or equivalent)                      Yes             No

       If ‘yes’ where and when did you obtain the certificate (formerly known as the Catholic Teacher’s Certificate in
       Religious Education)

       Please indicate your Registration Number (if known)

                                                                 1
Company limited by guarantee (No. 3492921)
Registered in England at 29 Tite Street, London. SW3 4JX
2.     PRESENT APPOINTMENT
       (a)    If teaching:
              Name and Address of Authority:
              (or employing body)                                             .

              …………………………………………………………………


              …………………………………………………………………

              Name and Address of
              School/College:

              ..…………………………………………………………………


              …………………………………………………………………..


              …………………………………………………………………..

              Type of Establishment: ……………………………               No. on Roll: (approx.) .. ..…………….

              Age Range:          ………………………………………              Date Appointed: …. ………………..

              Post:      …………………………………………………

              Spinal Point: …………… Allowances: ……………… Total Salary: …………………….


       (b)    If other than teaching:

              Nature of Post:
              ……………………………………………………………………………………..

              Name and Address of Employer:
              ……………………………………………………………………

               ……………………………………………………………. ……..

               ……………………………………………………………………

              Date Appointed:           ……………………… Salary: ………………………………………..

              Length of Notice: ……………………… ………………………….

              When could you commence duties? ………………………………..



3.     ADVERTISEMENT

       Please state where you learned of this vacancy:




                                                           2
Company limited by guarantee (No. 3492921)
Registered in England at 29 Tite Street, London. SW3 4JX
4.     EDUCATION
(a)    SECONDARY/FURTHER

       Name and Address of School/College                                      from                to         F/T*     P/T*




       * Please tick as appropriate

(b)    HIGHER (University, College, Polytechnic) – including professional qualifications and in-service
       courses leading to recognised qualifications.

           Names and Addresses of                Dates              Dates of      Qualifications        Subjects passed with
          University or College and/or       From     To   FT/PT     Exams          Obtained             details of Standard
          University Education Dept.                                                                          Obtained




5.     PROFESSIONAL IN-SERVICE COURSES ATTENDED OVER THE PAST THREE YEARS (other than
       in Paragraph 4(b))

                                                                                          Approximate
                    Subject/Course Details                    Organising Body                Date                Duration




                                                              3
Company limited by guarantee (No. 3492921)
Registered in England at 29 Tite Street, London. SW3 4JX
6.     REHABILITATION OF OFFENDERS ACT 1974
       You must answer the questions below and give details, if applicable, of the type(s) of
       offence(s), dates(s), sentence(s), fine(s) imposed.

            •   Have you ever been convicted of a criminal offence?                                           Yes          No

            •   Do you have any criminal charges or summonses pending against you? Yes                                     No

       If you have answered yes to any of the questions above, please give details on a separate sheet and put it in a
       sealed envelope and attach it to this form. This information will only be used if you are short-listed, otherwise it will
       be destroyed unopened. Please write your name on the envelope.

       N.B. All posts at St Elizabeths are subject to an enhanced disclosure from the Criminal
       Records Bureau.

7.     HAVE YOU AT ANY TIME BEEN DEBARRED FROM TEACHING BY THE
       DEPARTMENT FOR EDUCATION AND SKILLS OR THE GENERAL                                              Yes            No
       TEACHING COUNCIL?


8.     PAST EMPLOYMENT SINCE THE AGE OF 18 – Please indicate whether full-time or part-
       time and include any unremunerated activity to explain any gaps in employment.
       Please provide the information in chronological order.



                                                                                                 F/T             Dates
          Employer        Name and Type of School or         No.on         Post held and         or
                          Nature of other employment         roll           spinal point         P/T    From          To
                                                             (if
                                                             school)                                    Mth/Yr        Mth/Yr




                                                                  4
Company limited by guarantee (No. 3492921)
Registered in England at 29 Tite Street, London. SW3 4JX
9.     Of which of the following have you had at least one year’s experience? - (mark the number of
(a)    years in box)



       Mainstream Primary                         Mainstream Secondary            Sector College



       MLD                                        SLD                             PMLD


       SENCO                                      Careers                         PD/Sensory Imp


(b)    Have you ever had overall Responsibility for or held a recognised Supportive Role in the
       following: Please mark ‘R’ to show Responsibility ‘S’ to show Supportive Role.



       Staff Appointments                                        Timetabling


       Staff Organisation                                        Staff Training


       Staff Appraisal                                           Budget Control

(c)    Indicate if you have ever had Responsibility (R) or Professional Involvement (I) in the
       following areas of a Multi Disciplinary Service



       Residential Care of Students                              LAC Reviews



       On-site Therapy Services                                  School Nursing Provision



       Work Placements/Experience                                School Journeys/Trips


10.    PLEASE GIVE DETAILS OF ANY ABSENCES THROUGH ILLNESS DURING THE LAST
       FIVE YEARS.




                                                             5
Company limited by guarantee (No. 3492921)
Registered in England at 29 Tite Street, London. SW3 4JX
11.    ARE YOU, TO YOUR KNOWLEDGE, RELATED TO ANY TRUSTEE                 Yes        No
       OR OFFICER OF THE CENTRE OR OF THE GOVERNING BODY?
       If yes give details.


12.    OTHER RELEVANT EXPERIENCE, INTERESTS AND ABILITIES




        Continue on a separate sheet if necessary

13.    REFERENCES

       Please nominate three referees, at least one must be your present employer.



       Name:          ………………………………………… Designation: …………………………………

       Address:
       ……………………………………………………………………………………………………………..


       …………………………………………………………………………………………………………….


       Tel. No. …………………………………………




                                                           6
Company limited by guarantee (No. 3492921)
Registered in England at 29 Tite Street, London. SW3 4JX
       Name:          …………………………………… Designation: …………………………………….

       Address:
       …………………………………………………………………………………………………..


       …………………………………………………………………………………………………………….

       Tel. No. …………………………………………




       Name:          ………………………………………                          Designation: …………………………………….

       Address:
       …………………………………………………………………………………………………………….


       ……………………………………………………………………………………………………………

       Tel. No. …………………………………………


       Do you agree to your present employer being contacted at this stage concerning your
       application?   Yes       No


14.    NOTES TO APPLICANTS

       •    Before signing this form, please ensure that every section has been completed.
       •    Candidates are reminded that this is an application for a post in a Catholic Non
            Maintained School where the Governors are the employers and that the post will be
            subject to the terms and conditions of St. Elizabeth’s Centre.
       •    I understand that as St Elizabeth’s is a Christian organisation, I will be expected to
            support its Christian ethos.
       •    If I am appointed I give permission for St Elizabeth’s to contact awarding bodies,
            Colleges or Universities to verify any qualifications I have listed that are relevant to
            my appointment.
       •    I confirm that the information I have provided in this form and my supporting
            statement is accurate and complete.

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




                                                           7
Company limited by guarantee (No. 3492921)
Registered in England at 29 Tite Street, London. SW3 4JX
                                              ST. ELIZABETH’S CENTRE
                                          Notes for the Guidance of Applicants



   When completed, this form should be addressed to Deirdre Hancock, HR Manager, at the
   address on the front of the application form. Please ensure that you enclose your letter of
   Application.

   (a)     Importance will be placed on the letter of application the format of which is explained
           in the covering letter. No other material should accompany this form. Candidates are
           asked not to provide a curriculum vitae but to supply the information requested on the
           application form.

   (b)     Canvassing, directly or indirectly, will disqualify. Failure to disclose a family relationship to
           any Trustee or Governor may disqualify the applicant.

   (c)     St Elizabeth’s aims to be an Equal Opportunities employer and whole heartedly supports the
           principle of equal opportunities which covers all areas of employment. Its aim is to ensure
           that individuals are treated in a fair and non-discriminatory manner. It opposes all forms of
           unlawful or unfair discrimination on grounds of colour, race, nationality, ethnic or national
           origin, gender, marital status or disability.

   (d)     It will be appreciated that the Centre must be particularly careful to inquire into the character
           and background of applicants for appointment. It is, therefore, essential that, in making an
           application candidates should be aware that it will be necessary to disclose whether they
           have any convictions and, if so, for what offences. This post is exempt from the provisions
           of Section 4(2) of the Rehabilitation of Offenders Act 1974, by virtue of the Rehabilitation of
           Offenders 1974 (Exceptions) (Amendments) Order 1986. Applicants are, therefore, not
           entitled to withhold information about convictions which for other purposes are “spent” under
           the provisions of the Act. In the event of employment being taken up, any failure to disclose
           such convictions could result in dismissal or disciplinary action by the School. The fact that
           a conviction has been recorded against you will not necessarily debar you from
           consideration for this appointment.

   (e)     Any personal information entered on the application form may be held on computer files.

   (f)     Candidates recommended for appointment will be required to complete a medical
           questionnaire, which will be supplied after the interview. This will be submitted to the
           Centre’s Medical Officer/or the Occupational Health Service, and the candidate will be
           required to undergo a medical examination.

   (g)     On the grounds of economy, it is no longer the practice to acknowledge receipt of
           application forms unless a stamped addressed envelope is provided by the applicant for that
           purpose. The covering letter gives a timetable for the appointment and this opportunity is
           taken to thank all candidates for their interest in the post for which they have applied.




                                                           8
Company limited by guarantee (No. 3492921)
Registered in England at 29 Tite Street, London. SW3 4JX

								
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