EMPLOYMENT APPLICATION FORM Lethbridge Primary School Lethbridge Road Swindon Wiltshire SN1 4BY Tel: 01793 535033 E-mail: admin@lethbridgeprimary.co.uk Applicant s Name Title of post applied for GUIDANCE FOR COMPLETING THIS FORM Please read through this information carefully before completing the Application Form. Try to complete the form in full; we will compile a shortlist of candidates for interview based on the information that we receive. Covering letters are also welcomed. Please do not enclose a Curriculum Vitae with your form unless this is specifically requested. Space is available at the end of the form for additional information, should you feel that this is required If you need more space than is available on the form then please use additional sheets of paper. These should be attached to the form and marked clearly with your name and the post for which you are applying Please complete the form using black ink, or type Please Note: o o The appointment is subject to satisfactory evidence of medical fitness and clearance from the Criminal Records Bureau. If your application is successful, the information that you give on this form will be used to compile your personal file and will be stored in a computer in accordance with the Data Protection Act 1998. Completion and submission of this form is taken as consent to process the information that you have provided. Page 1 of 8
1. PERSONAL DETAILS Surname Other names Teacher number Title Date of birth Address Postcode Mobile Telephone Email Address Do you require a Certificate of Sponsorship (formerly Work Permit)?: YES/NO Home Telephone Work Telephone Preferred method of contact: Expiry Date of Current Certificate/Permit (if applicable): 2. PRESENT / MOST RECENT EMPLOYMENT Name of employer Job Title Full time / part time / supply Main duties Reason for wishing to leave or left Start Date End Date Pay scale & details of allowances / enhancements Page 2 of 8
3. PREVIOUS EMPLOYMENT (most recent appointment first, continuing on an additional sheet if required) Employer Job Title Brief Description of Duties Annual Salary & allowances From Dates To Posts working with Children, Young People and Vulnerable Adults If you are applying for a post which involves working with children, young people and or vulnerable adults, you are required to provide below the dates you were employed from and to and details of any gaps in your employment. ALL convictions/cautions must be declared (regardless of whether deemed as spent) Page 3 of 8
4. EDUCATION & OTHER PROFESSIONAL QUALIFICATIONS Please include all relevant to the post. Subjects currently being studied should also be included Subject/qualification(s) Place of Study Grade/result Year 5. LEARNING & DEVELOPMENT (any relevant courses that you have attended or are currently undertaking) Course Title Training Provider From Dates To Page 4 of 8
6. FURTHER INFORMATION. Please add any further information that you feel may support your application. You can attach further sheets and/or a covering letter if you wish. Page 5 of 8
7. REFEREES References will be requested prior to interview. Please tick here if you wish to be consulted prior to an approach being made to your current employer for a reference: Please state names and addresses of two persons to whom reference may be made. One must be your present line manager/employer (or previous employer if not currently employed). If you are self-employed then this should be a client, accountant or solicitor. The second referee should be someone who you have known for at least three years and who is currently employed in a position of responsibility. They should be someone who is able to comment on your aptitude for the post and should not be a relative. 1. Present/Most Recent Employer: Name Position/Job Title Address Contact details e-mail address: Tel No: 2. Name Position/Job Title Address Contact details e-mail address: Tel No: 3. Name Position/Job Title Address Contact details e-mail address: Tel No: Page 6 of 8
8. MONITORING INFORMATION. This section will be detached from your application form and will be used for monitoring purposes only. Race relations (Amendment) Act 2000 I would describe my ethnic origin as: White British Irish Italian Polish Any other white background, please specify. Mixed Heritage (tick all that apply) Asian Black African Black Caribbean Chinese White Any other Mixed heritage, please specify... Asian or Asian British Bangladeshi Indian Pakistani Any other Asian background, please specify Black or Black British African Caribbean Any other black background, please specify. Chinese or other ethnic group Chinese Any other background, please specify Are you related to or closely acquainted with any Governor or staff member at Lethbridge Primary School? The Working Time Regulations place a maximum limit on weekly hours worked. Will you continue in other employment, should you be offered this position? YES YES NO NO If yes, how many hours per week? Page 7 of 8
Please state how you found out about this post (including name of publication where relevant) Do you consider yourself disabled? If you have a disability, do you wish to be considered under the Guaranteed Interview Scheme if you meet the minimum criteria as specified in the Person Specification? YES/NO YES/NO Please indicate if you will need any special help or assistance if you are invited to interview. Religion Sexual Orientation 9. DETAILS OF ANY CONVICTIONS The Rehabilitation of Offenders Act helps rehabilitated ex-offenders back into work by allowing them not to declare criminal convictions to employers after the rehabilitation period set by the Court has elapsed and the convictions become spent. During the rehabilitation period, convictions are referred to as unspent convictions and must be declared to employers. Since you are applying for a post involving working with children any offer of employment will be subject to a satisfactory disclosure from the Criminal Records Bureau. You are required to declare all convictions/cautions regardless of whether deemed as spent. Failure to reveal information relating to any convictions could lead to withdrawal of an offer of employment. IT IS A CRIMINAL OFFENCE TO APPLY FOR A POST WORKING WITH CHILDREN IF YOU ARE BANNED UNDER THE PROTECTION OF CHILDREN ACT. Have you any criminal convictions, cautions, warnings YES/NO or reprimands? If yes, please give details on a separate sheet (including date and sentence imposed) 10. DECLARATION The information in this form is true and complete. I agree that any deliberate omissions, falsification or misrepresentation in the application form will be grounds for rejecting this application or subsequent dismissal if employed by Lethbridge Primary School. I agree to the above declaration Signature Name Date Page 8 of 8