An All-Through Co-Operative School

An All-through Co-operative School

Application for a Teaching Appointment

Post Applied For: ………………………….…... Subject: ...... ………………………………………

Common Pay Scale:  or Incentive Allowance:  (Please indicate)…………………………………..

Closing Date for Completed Form: …………………………………………………...……………………

Please return this form to: Beth Kobel, Head, Preston Manor School, Carlton Avenue East, Wembley, Middlesex HA9 8NA

When could you take up duties if appointed?......

Please read all instructions carefully before completing this form. Please use black ball pen or typescript since it will be necessary to photocopy your application form. This application form should be completed in full. You may enclose your curriculum vitae for additional information, if you wish, but not as a substitute for filling in all sections of this form.

Mr  Mrs  Ms  Surname: …………………………………………………………………

Other Names: (Block capitals)……………………………………………………………………......

Home/Correspondence Address (In full):………………………………………......

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

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

Telephone No: Daytime………………………………… Evening….………………………………………..

E-mail Address:………………………………………………………………………………………………..

Date of Recognition as a Qualified Teacher by the Department for Education and Skills

(DfES)……………… and DfES No:…..…………………

Have you successfully completed a period of probation? Yes  No  If yes, with which Authority?......

Date of completion of probation:……………………………………………………………………………

Do you need a work permit to work in this country? Yes  No 

National Insurance No: ………………………………………………………………………………… 1

Updated 15.11.16 Secondary / Further Education

(Where applicable please include details of examinations which have been or are about to be taken but results of which are not yet available). If educated outside the European Community please note that the School is required to confirm that you have acquired a standard in English and Mathematics which is equivalent to at least grade C GCSE Ordinary Level. Please give details.

School/College Subject Qualification gained Grade Date (e.g.: GCSE ‘A’ Level etc.)

Further Education / Teaching Qualifications

Name of College/ Qualifications Grade/Class Date Date University and address if & Subjects If applicable From To outside the UK

2 Other qualifications related to current or previous employment

Name of Professional Body Membership Grade Was Membership gained Date by examination

Relevant Inservice Courses

Course Qualifications gained Dates showing (If applicable) duration

Voluntary/Unpaid work and interests

Details Dates

Outside interests and activities: ……………………………………………………………………………………………….…......

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

…………………………………………………………………………………………………………………… 3

Updated 15.11.16 Employment History

(Include details of vacation employment if you are a college leaver) Please give full details as this sections is used for salary assessment purpose.

Name/address of Position/Post From To Basic Other Total present (or most Salary Allowances Remuneration recent employer) If you work in a school/college please state name/ address

*Name/address of Position held Age range From To Reason for leaving previous employers and allowance taught if (starting with the most if applicable applicable recent) Please state name of school/college if applicable

*Continue on separate sheet if necessary 4

4 Please make full use of this section, attaching additional sheets if necessary, to provide further information in support of your application, a maximum of 2 sides A4 paper Ariel font point 11. Please be sure to show how your education, training, experience and qualifications fit you for this post. Please explain any gaps in employment history. Shortlisting will be conducted only on the basis of written applications. It is therefore essential that all applicants, both internal and external, should complete this section of the application form.

5 Referees

Please give the names of two people to whom references can be made. One referee should normally be your current/most recent Headteacher/Employer and be able to give information about your skills and abilities which are relevant to your application. The other referee should preferably be work related and be someone who can comment on your suitability for the post e.g. line manager or other qualified person with whom you have worked closely. Relatives may not be given as referees. Beginner or newly qualified teachers can give the name of a Headteacher or university tutor/lecturer as a referee instead. References will be requested at the time of interview.

Name:………………………………………………………………………………………………

Occupation:………………………………………………………………………………………..

Address:……………………………………………………………………………………………

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

E-mail Address: ………………………………………………………………………………………………………

Telephone:………………………………………… Facsimile:…………………………………

Name:………………………………………………………………………………………………

Occupation:………………………………………………………………………………………...

Address:……………………………………………………………………………………………

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

E-mail Address: ………………………………………………………………………………………………………

Telephone:………………………………………………Facsimile………………………………

6 Criminal Convictions By Law, spent convictions must be disclosed. Please give details of any criminal convictions (not including minor traffic offences). If you have no convictions please write ‘none’.

Under Part II of the Criminal and Justice and Court Services Act 2000, it is a criminal offence for any individual to apply, accept or continue to work with children if they are disqualified from working with children. It is a condition precedent of any such employment that the person does not have any such disqualification and if they do, the employment will automatically come to an end.

HAVE YOU EVER BEEN DISQUALIFIED FROM WORKING WITH CHILDREN? Yes  No 

IMPORTANT NOTE: CRIMINAL RECORD BUREAU CHECKS WILL BE UNDERTAKEN FOR ALL CANDIDATES SUCCESSFUL AT INTERVIEW PRIOR TO THEIR COMMENCEMENT

Declaration

I hereby declare that I have understood and complied with the requirements laid down in the previous paragraph and I agree that the information given on this form may be used for registered purposes under the Data Protection Acts, 1984/1998. I have also understood and complied with the provisions concerning the disclosure of criminal convictions.

Providing any misleading or false information to support your application or canvassing, directly or indirectly with anyone likely to be involved in the appointment process will disqualify you from appointment, or if appointed will render you liable to dismissal without notice. This School is under a duty to protect the public funds it administers and to this end may use the information you have provided on this form for the prevention and detection of fraud. It may also share this information with other bodies administering public funds for this purpose e.g. other schools, councils etc.

Signature of Applicant: …………………………………………………………………………………………...

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

PRESTON MANOR SCHOOL Carlton Avenue East, Wembley, HA9 8NA. Head: Ms Beth Kobel. Telephone: 020 8385 4040/4594. Facsimile: 020 8385 4590. E-mail: [email protected] www.preston-manor.com

7 Information for Monitoring

Position applying for: …………………………………………………………………………. All applicants must complete this section, as the information will enable us to monitor the effectiveness of our Equal Opportunities Policies. Please tick the appropriate boxes.

Ethnicity: Asian Black White Chinese Other  British  British  Irish  Chinese  Please specify  Bangladeshi  African  UK  British ……………………  Indian  Caribbean  Other (please  Other  Pakistani  Other specify)……….. (please  Other (please specify) (please specify) ……………. specify) ………. ……………

Gender: Male  Female 

Date of Birth ______

Disabled: Yes  No 

If you are applying for job sharing do you have a job share partner? Yes/No: if yes please give their name and address:……………………………………………..………….… ……………………………………………………………………………………………………… ……………………………………………………………………………………………………… Please give dates on which you will NOT be available for interview e.g. holidays: …………...... …………………………………………………………………………………….

How did you hear of this job? Please state the publication in which you saw it advertised: …………………………………………………………………………………………