On Track Education Services Limited

On Track Education Services Limited Bedford i-Lab Stannard Way Priory Business Park Bedford MK44 3RZ Telephone: 01234 834893 Email: [email protected] Application for Employment

All information will be treated as strictly confidential. On Track Education Services is committed to safeguarding and promoting the welfare of children and expects all staff to share in this commitment. Applicants must be willing to undergo child protection screening appropriate to the post, including checks with past employers and the Disclosure and Barring Service. Please print clearly. All sections must be completed

Position applied for:

Name of school / service:

1. PERSONAL DETAILS

Do we need to make any disability-related adjustments to Y / N Suggestions: allow you to take part in the recruitment process?

Title: Forename(s):

Surname: Any former names:

Home address and postcode:

e-mail address:

Home phone Mobile number: number:

Date of birth: NI Number:

DBS check number Are you registered with and date : the DBS update service?

Do you have a Do you have use of a current, clean car? driving licence?

(QTS only) GTC/IFL Do you have any registration restrictions on taking up number: employment in the UK?

DOCUMENT FORMAT REVIEWED January 2016 BY PH Page 1 of 6 1. EDUCATION, QUALIFICATIONS AND TRAINING

Please give details of Secondary and Further Education, including any ‘A’ Levels and equivalent vocational courses. You will be asked to provide original certificates at interview.

School/College/Institution Dates (mm/yy) Qualifications gained / Grades / Exam Body From To

Please give details of any Higher Education and equivalent courses. You will be asked to provide original certificates at interview.

College/University/Institution Dates (mm/yy) Qualifications gained / grades / awarding body / date achieved From To

Please give details of other professional or vocational qualifications you hold that are relevant to your application. You will be asked to provide original certificates at interview.

Dates obtained Qualifications obtained, grade and level Name of awarding body

DOCUMENT FORMAT REVIEWED January 2016 BY PH Page 2 of 6 2. PRESENT OR MOST RECENT EMPLOYMENT

Post held: Start date:

Notice required: End date:

Reason for leaving:

Employers name and address:

Email address: Final salary:

Post code: Telephone number:

Please give a brief description of your current or last post and responsibilities:

3. PREVIOUS EMPLOYMENT

Please give details of all previous employments, full and part time, paid or unpaid, including those in a voluntary capacity. Please list in order, starting with the most recent first.

Job Title Employer (name and Dates (mm/yy) Duties and reason for address) leaving From To

DOCUMENT FORMAT REVIEWED January 2016 BY PH Page 3 of 6 If there are any gaps in your employment history, please give details:

Are you related to, or have a close relationship to Y / N any existing On Track employees, employers or If Yes please give details of person(s) and Company Directors? relationship:

4. SUPPORTING STATEMENT

Please give below your reasons for applying for this job. Please tell us in your own words how your experience, skills and knowledge relate to the Job Description and set out how you meet the requirements of the person specification You should also give any other information which you feel will assist us in considering your application:

5. REHABILITATION OF OFFENDERS ACT 1974 (EXCEPTION) ORDER 1075

This post involves contact with children and is exempt from the Rehabilitation of Offenders Act 1974 and all subsequent amendments (England and Wales). For these positions you are not entitled to withhold information about police cautions, ‘bind-overs’ or any criminal convictions that include any that would otherwise be considered ‘spent’ under the Act. The amendments to the Exceptions Order 1975 (2013) provide that certain spend convictions and cautions are protected and are not subject to disclosure to employers, and cannot be taken into account. Guidance and criteria on the filtering of these cautions and convictions can be found at the Disclosure and Barring Service website. Do you have any unspent convictions, cautions, reprimands or warnings?

DOCUMENT FORMAT REVIEWED January 2016 BY PH Page 4 of 6 If yes, please give details on the Self Disclosure Form and bring with you to interview

6. REFERENCES

References: Reference Information must be completed in full. Please provide the names, address, email and phone number of two referees who can comment on your suitability for this position. If you have been or are in employment, one must be your present or most recent employer. References will not be accepted from relatives, or persons who only know you as a friend. If shortlisted, references will be taken up prior to interview. If you are currently working with children we will ask your current employer if you have any disciplinary offences relating to children, including any for which the penalty time has expired. Character reference: Professional reference: (a professionally qualified person of recognised (current or previous employer in work with children. standing in the community who has known you This person will also be phoned on receipt of the reasonably well for at least two years) reference)

Name: Name:

Position: Position:

Address: Address:

Telephone: Telephone:

E-mail: E-mail (professional email address only):

Your connection with above person: Your connection with above person:

 I am able to provide evidence that I have a right to work in the United Kingdom  I understand that if my application is successful an Enhanced DBS will be obtained

Please notice: Providing false information is an offence and could result in your application being rejected, or summary dismissal following selection and possible referral to the police and/or DBS. Declaration: I declare that the above information is true. I understand that any job offer made on the basis of untrue or misleading information may be withdrawn or my employment terminated. I declare that I am not banned or disqualified from working with children nor subject to any sanctions or conditions on my employment imposed by any regulatory body.

Signed:

DOCUMENT FORMAT REVIEWED January 2016 BY PH Page 5 of 6 Date:

On Track Education Services Limited by Guarantee Company No: 5363653

DOCUMENT FORMAT REVIEWED January 2016 BY PH Page 6 of 6