Job title: Please enclose a copy of the job description Date appointed to this post: Salary: Date available to begin new job: Full Chronological History Please provide a full history in date order, most recent first, since leaving secondary education, including periods of any post-secondary education/training, and part-time and voluntary work as well as full time employment, with start and end dates, explanations for periods not in employment or education/training, and reasons for leaving employment. Job or positon Name and address of school, other employer, or description of activity Number on roll and type of school, if applicable (DD/MM/YYYY) Reason for leaving From To
Secondary Education and Qualifications Name of school/college From To Examination passed (i.e. A GCSE), subject and grade Higher Education Name and address of university, college and/or university education department Dates Full or part-time Courses/subjects taken and passed Date of examination and qualifications obtained Age groups for which trained From To
Part 2 Internal Ref. No. This section will be separated from Part 1 on receipt. Relevant responses may be verified prior to shortlisting and/or used for administration purposes but will not then be used for selection purposes. Information Surname or family name: All forenames: Title: Current address: Postcode: Home telephone number: Mobile telephone number: Email address: DfE reference number: Do you have a current full clean driving licence? Only applicable for posts that require driving Yes No Do you require sponsorship (previously a work permit)? Yes No If YES please provide details under separate cover. Declaration of any Convictions, Cautions or Reprimands, Warnings or Bind-overs It is the School’s policy to require all applicants for employment to disclose any previous ‘unspent’ criminal convictions and any cautions which have not expired, or any pending prosecutions. In addition, the job you are applying for is exempt from the provisions of the Rehabilitation of Offenders Act 1974 (exceptions order 1975) which requires you to disclose all spent convictions and cautions except those which are ‘protected’ under Police Act 1997 – Part V and the amendments to the Exceptions Order 1975 (2013) and are not subject to disclosure to employers on DBS certificates and cannot be taken into account. Guidance on the filtering of “protected” cautions and convictions which do not need to be disclosed by a job applicant can be found on the . If you are invited to interview you will be required to disclose your criminal record on an “Invitation to Interview” form and bring the completed form to interview. If the job involves contact with children up to age 8 you will also be required to make a Disqualification Declaration. The information you give will be treated as strictly confidential. Disclosure of a conviction, caution, bind-over order, warning or reprimand will not automatically disqualify you from consideration. Any offence will only be taken into consideration if it is one which would make you unsuitable for the type of work you are applying for. However, offences relating to children may make you unsuitable since this is a “regulated position” under the Criminal Justice & Courts Services Act 2000. from Teaching In accordance with the requirements of The School Staffing (England) (Amendment) Regulations 2013, any future appointment is subject to a check with the Department for Education to ensure that you are not subject to a prohibition order or an interim prohibition order.