Application Form Sup by nuhman10

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									 Subject(s) applied for

 Level(s)
                For more information on CIE qualifications please refer to www.cie.org.uk/qualifications

Personal Details

 Title*          Surname*                                            Forename(s)*




 Home Address*
 (Inc. Postcode)

 Email                                                           Home Telephone*
 Address*                                                        (Inc. Area Code)

 Work Telephone
                                                                 Mobile Number
 (Inc. Area Code)
*Mandatory Information


Employment History

 Present Appointment

 Appointment                                                            Date Appointed

 School/Employer

 Subject(s) & Level(s)


 Previous Appointment(s)

 Appointment                                                            From                     To

 School/Employer

 Subject(s) & Level(s)



 Appointment                                                            From                     To

 School/Employer

 Subject(s) & Level(s)



                                                                            Examiner / Moderator Application Form
Examination Board Experience (External Examining/ Coursework Moderation)

 Board                                                       Subject


 Level                                                       Role*


 Examiner Number                                                        From                               To



 Board                                                       Subject


 Level                                                       Role*


 Examiner Number                                                        From                               To



 Board                                                       Subject


 Level                                                       Role*


 Examiner Number                                                        From                               To

  *Please state whether Principal Examiner, Team Leader, Assistant Examiner, Principal Moderator, etc.



University Degree or other relevant qualifications

 Awarding institution                                                                            Qualification


 Class / Grade         Subject                                                                   Date awarded




 Awarding institution                                                                            Qualification


 Class / Grade         Subject                                                                   Date awarded




 Awarding institution                                                                            Qualification


 Class / Grade         Subject                                                                   Date awarded




                                                                                           Examiner / Moderator Application Form
Availability

  Please indicate which examination periods you would be free to undertake work:

  Summer: Overall marking period: May – July                 Yes/No*

  Winter:   Overall marking period: October - January        Yes/No*

  Can you attend meetings:                        Weekdays?         Yes/No*              Weekends?           Yes/No*
                                                                                                * Please delete as appropriate


  Do you expect that your time would be taken up by other external examining work? If so, please give details:




  Do you or the school where you teach, prepare candidates for any Cambridge Assessment (OCR, CIE or ESOL) suite of
  examinations? If so, please give details?




  Please use the space provide to add any additional information/ experience to support your application:




Electronic Script Management

  CIE is committed to various forms of electronic script management (ESM). In order to mark using these systems you
  need to have a PC running Windows 7, XP or Vista and a broadband internet connection. If you are interested in taking
  part in the new developments you will need to visit the hardware validation webpage at:
  https://www.ca.scoris.rm.com/ehv/index.aspx

  Please make a note of your Validation Reference Number and enter it below:



  Validation Reference Number:



  If you have not entered a Validation Number please give the reason below (e.g. Do not own a PC, Failed validation test)




                                                                              Examiner / Moderator Application Form
Supplementary Form for Examining Work in Languages other than English

 In addition to your application for examining work, would you
                                                                                Yes/No*
 be interested in setting examination questions?


 For each of the following skills, please indicate your level in the target language

 Speaking        Native speaker/ Fluent/ Moderately fluent*
 Writing         Native speaker/ Fluent/ Moderately fluent*
                                                                          * Please delete as appropriate


 Have you ever taught literature?                 Yes/No*




 Would you feel confident to examine literature?                Yes/No*




 Would you be interested in being a visiting Oral Examiner for the Cambridge Pre-U
                                                                                                           Yes/No*
 (you would need to be available for visits to schools between March and June)?



 How do you maintain your contact/connection with the target language?




 Tell us why you think your experience makes you suitable to be an Examiner/Moderator in the target
 language:




 Do you have a UK Bank Account? (Yes/No) Please do not provide details of your account on this form




                                                                                 Examiner / Moderator Application Form
References

 CIE require details of two referees. Please state the relationship between yourself and the referee; references will not
 normally be accepted from spouses, partners and close family members. Referees will be contacted by email in the
 first instance. Please note that personal email addresses should be provided where possible to prevent delays during
 school holidays.


Personal / Professional reference to be provided by Applicant

 Name*                                                     Official Position*

 Email Address*                                            Relationship *


 Postal Address
 (inc. Postcode)


Professional reference to be taken up by CIE

 Name*                                                     Official Position*

 Email Address*                                            Relationship *


 Postal Address
 (inc. Postcode)

*Mandatory Information

Declaration

 By completing and returning this application you consent to UCLES seeking and receiving relevant information held by
 other exam boards regarding your performance as well as giving consent to UCLES to disclose such information should
 any other exam board make a request for a relevant reason.

 I certify that the information I have given in this application is true and complete to the best of my knowledge and that
 I include a personal reference to support my application.


 Signed      Please type name here                                                  Date




                Please email your completed application form and reference to: recruitment.c@cie.org.uk

            Or post to: Examiner Recruitment, CIE Examiner Management, 1 Hills Road, Cambridge, CB1 2EU




                                                                                Examiner / Moderator Application Form

								
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