Exeter Royal Academy for Deaf Education

JOB APPLICATION FORM Exeter Royal Academy for Deaf Education 50 Topsham Road Exeter, Devon EX2 4NF

Registered Charity No 1124523

This form can be completed as a Word document. Email [email protected] for a template.

Post: ......

Reference Number (to be completed by Human Resources Department):……………………………..

Section A

References Please give below the names, addresses and telephone numbers of two individuals who have agreed to provide a reference on your behalf and including your present or most recent employer.

CURRENT/MOST RECENT EMPLOYER:

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

Referees Job Title: Referees Job Title:

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

Referees e-mail address: Referees e-mail address:

...... For office use only: For office use only:

Please tick if you would prefer us not to approach your current employer prior to interview.  Secondary, further education and other qualifications – please list all qualifications obtained. As part of the recruitment process, we will check original certificates against the qualifications stated below.

DATES ESTABLISHMENT EXAMINATIONS PASSED Date Subject Level Grade (GCSE, ‘A’ etc)

2 Employment history – Please set out in chronological order exact dates of all employment ever held since leaving secondary education, this includes both part-time, volunteering and temporary work.

Please provide start and end dates and explanations for periods not in employment, education or training.

Please continue on separate sheet if necessary.

If there are unexplained gaps in employment and/or months and years not included then we are afraid that the Academy will be unable to consider your application any further.

EMPLOYER Dates Position Reason for Salary and other (names and full addresses) MM/YY change benefits in chronological order: From To Current/Most Recent Please include Employer: salary scale point if known. Section B

Why do you wish to take up this post? Continue on a separate sheet if necessary.

Please explain how you meet the Person Specification for this role. Continue on a separate sheet if necessary. It would be helpful if you could explain how you meet each of the Essential Requirements of the Person Specification.

4 What are your other interests, activities and hobbies?

Section C

Have you ever been convicted of a criminal offence? If so, please provide details.

What is the earliest date on which you could take up employment?

Is there any confidential information pertinent to your application that we should be aware of? Applicants should be aware that appointment is subject to:  Receipt of written references, which are considered satisfactory by the Academy.  A completed staff suitability declaration form, which is considered satisfactory by both the Academy and Ofsted.  A enhanced DBS check considered satisfactory by the Academy,  Proof of relevant qualifications,  A clear list 99/barred list check.  Eligibility to work in the UK.

I confirm that the statements made in this application are, to the best of my knowledge, accurate and I authorise you to make such further confidential enquiries relating to the application as may be considered necessary (present employer excluded).

Any offer of employment may be withdrawn if it is found that false information has been included on the application form.

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

Print Name:......

Please return, marked for the attention of the Human Resources department: Exeter Royal Academy for Deaf, 50 Topsham Road, Exeter EX2 4NF or [email protected] (Telephone: 01392 267096) Diversity Monitoring FORM Exeter Royal Academy for Deaf Education 50 Topsham Road Exeter, Devon EX2 4NF Registered Charity No 1124523

Reference Number (office use only): ......

Post title: Full name: Address:

Post Code:

Home Telephone

Mobile Telephone

E-mail address:

Gender: Male  Female 

Date of birth:

Marital status: Married  Single Other  Prefer not to say 

Sexual Orientation Bisexual  Gay man  Gay Women/Lesbian  Hetrosexual 

Do you have responsibility for dependants? (Dependants relates to children, or elderly or other persons for whom you are the main carer.) YES/NO

Do you have any disabilities? Under the Equality Act 2010 a disability is defined as physical or mental impairment which has a substantial and long-term adverse effect on a person’s ability to carry out normal day to day activities. YES/NO

Nationality:

Ethnic origin (Relates to a sense of identity/belonging on the basis of race/culture). I would describe myself as (choose ONE section from A to E, and then tick the appropriate box to indicate your cultural background):

A White: British English Scottish Welsh

6 Irish Other, please specify: B Mixed: White and Black Caribbean White and Asian White and Black African Other, please specify: C Asian, Asian British, Asian English, Asian Scottish or Asian Welsh: Indian Pakistani Bangladeshi Other, please specify: D Black, Black British, Black English, Black Scottish, or Black Welsh: Caribbean African Other, please specify: E Chinese, Chinese British, Chinese English, Chinese Scottish, Chinese Welsh, or other ethnic group: Chinese Other, please specify: Prefer not to states Religious Belief (please tick as appropriate) Buddhist Jewish Other Christian Muslim None Hindu Sikh Do not wish to answer

Where did you see this post advertised?

Data protection: Information from this application may be processed for purposes registered by the Employer under the Data Protection Act 1998. Individuals have, on written request [and on payment of a fee] the right of access to personal data held about them. I hereby give my consent to Exeter Royal Academy for Deaf Education processing the data supplied in this form for the purpose of recruitment and selection.

Applicant's Date: signature:

The information you provide will be treated as strictly confidential and will be used only for Equal Opportunities purposes. It will not be forwarded to recruiting mangers. It will not be taken into consideration for short-listing or interviewing purposes.