Teaching Application Form

Vacancy Reference Number* Application for the post of School Name or Job Location

Personal Details

Surname* First Name* E-mail Address* Home Contact Number* Work Contact Number* Mobile Contact Number GTC Reg No./DFE Ref Number/Teacher No*

Employment

Current Employer Name* Current Employer Address* Current Work Address (if different from Employer Address) Current Post Held* Date Appointed* Current Annual Salary* Point on pay spine* Additional responsibility points (If applicable) Age range of pupils* Number on roll* Brief description of duties*

Previous Employment*
	Employer	Post	Grade Scale	Full time or Part-time	Start Date	Leave Date	Reason for Leaving

Education and Training

Please fill in the following*
	Start Date	End Date	Full Time or Part-time	Name of Educational Establishment	Qualification Gained	Grade	Date awarded

Continue here if necessary

Details of Teacher Training (For Newly Qualified Teachers ONLY)

Please confirm current status of Induction Period including dates/outcomes or reviews

Education trained forPrimarySecondaryFurther Education

Age Range Main Teaching Subject Subsidiary Subject(s) Other recent courses and INSET in which you have been involved in the past 3 years and which you consider relevant to this post

Periods of Unremunerated Activity

(After the age of 18 years. e.g. Raising family, unpaid voluntary work, etc)
	How Time was spent	Date From	Date To

Additional Information

You may wish to include additional information in support of your application. This should be brief but in any case no more than two sides of A4 size paper. This additional information should include some indication of why you are interested in this particular post and what experience, interests and skills you can offer in relation to the job description/person specification.

References

Main Reference

Name Position Held Organisation (If applicable) Address Contact Phone number E-mail Address How long known?

Primary Reference

Name Position Held Organisation (If applicable) Address Contact Phone Number E-mail Address How Long Known?

Do we have your permission to approach the above prior to interview?YesNo

If no, you may wish to give reason(s)

General

You are required to declare below any relationship with or to a Trustee or member of staff within the East Midlands Education Trust.

Please state name, relationship and school (if relevant):

Have you ever been the subject of formal disciplinary proceedings?YesNo

If 'Yes' please give brief details including dates

Disclosure of Criminal Background

The Authority is required under the Police Act 1997, the Protection of Children Act 1999 and the Criminal Justice & Court Services Act 2000 to check the criminal background of those employees whose jobs give them access to children or other vulnerable members of society. Decisions to appoint will be subject to consideration of a disclosure from the Disclosure and Barring Service.

Due to the nature of the work for which you are applying, this post is exempt from the Rehabilitation of Offenders Act 1974 and therefore you must provide information about all convictions, including those which for other purposes are ‘spent’ under the Provisions of the Act.

Have you ever been convicted of a criminal offence?YesNo

Have you ever been cautioned for a criminal charge?YesNo

Are you at present the subject of a criminal charge?YesNo

If 'Yes' to any of the above questions, please give brief details including dates

Health/Medical Details

Successful applicants will be required to complete a confidential medical questionnaire and may be required to undergo a medical examination.

Additional Information

Is there any other information relevant to the recruitment process that you would like to advise us of, or any dates that you are not available for interview?

Data Protection Privacy Statement

The personal data that you provide within your application will be used for shortlisting and interviewing purposes and for contacting you about the recruitment process. If you chose to complete the sections on the final two pages of the application form, this data will be used only for monitoring purposes and will be anonymised. Your application will be stored securely and only used for purposes directly relevant to the recruitment process.

If you are appointed, your application will be placed onto a secure employment file. Details for unsuccessful candidates will be destroyed six months after the recruitment process concludes.

We do not share information about you with any third party without your consent unless the law allows us to do so.

The school is the ‘data controller’ for the purposes of data protection law.

By Selecting 'Yes' you are consenting for your data to be used as described above. You may withdraw this consent at any time.

Select one of the following

Declaration

I declare that, to the best of my knowledge and belief, the information given on ALL parts of this form is correct. I understand that, should my application be successful and it is discovered subsequently that information has been falsified, then disciplinary action may be taken which may include dismissal from the post.

I confirm that I have a legal right to work in the UK and if this application is successful, I undertake to produce appropriate documentary evidence to prove this, prior to commencing work with the Trust.

The East Midlands Education Trust is committed to safeguarding and promoting the welfare of children and young people and expects all staff and volunteers to share this commitment

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