CONFIDENTIAL TEACHER APPLICATION FORM NAME OF

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CONFIDENTIAL
TEACHER APPLICATION FORM
(Before completing this form please read Notes to Applicants)
NAME OF CANDIDATE:
TO BE USED FOR THE FOLLOWING TEACHING POSITIONS ONLY:-
Advanced Skills Teacher
Excellent Teacher
Fast Track Teacher
Teacher
Newly Qualified Teacher
Instructor
Please use the latest version of this application form which can be downloaded from the
Catholic Education Service website: www.catholiceducation.org.uk
BEFORE YOU BEGIN PLEASE CHECK THAT YOU HAVE THE FOLLOWING:1. Application Form
2. Notes to Applicants
3. Recruitment Monitoring Form
4. Rehabilitation of Offenders Act 1974 – Disclosure Form
Model Application Form – Teacher – version 10 – April 2013
THE CATHOLIC EDUCATION SERVICE ©
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PLEASE DO NOT RETURN ANY COMPLETED APPLICATION FORMS AND/OR
SUPPLEMENTARY DOCUMENTS TO THE CATHOLIC EDUCATION SERVICE. PLEASE
RETURN ALL COMPLETED APPLICATION FORMS AND/OR SUPPLEMENTARY
DOCUMENTS TO THE SCHOOL/COLLEGE WHERE THE POSITION APPLIED FOR IS
BASED, OR AS INSTRUCTED IN THE DETAILS OF THE POST.
DETAILS OF ROLE APPLIED FOR
Application for the position of:
Full Time:
Part Time:
Job Share:
At:
At which the Governing Body is the employer of staff
In the Local Authority of:
In the Archdiocese/Diocese of:
Please state where (or how) you first learned of this vacancy:
Model Application Form – Teacher – version 10 – April 2013
THE CATHOLIC EDUCATION SERVICE ©
VA School
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1. APPLICANT’S PERSONAL DETAILS
1.1
1.1.1
Title:
1.1.2
Surname:
1.1.4
Known as (if applicable):
1.1.6
Date of Birth:
1.1.8
Address:
1.1.3
First Name(s):
1.1.5
1.1.7
Any
former
name(s):
Religious Denomination
/Faith:
1.1.9 If you have lived at this address for less than 5 years, please list all other addresses
at which you have lived during this period with dates:
Address
Dates
1.1.10 Telephone numbers:
Home:
Mobile:
Work:
1.1.11 Email Address:
1.2
How do you prefer to be contacted?
1.3
National Insurance No.:
1.4
DfE Teacher Reference No.:
1.5
Do you have Qualified Teacher
Status (“QTS”)?
1.6
QTS Certificate No.:
1.7
Date of qualification
as a Teacher:
1.8
GTC (Wales only) or other Membership No.:
1.9
Do you hold a full and valid UK Driving Licence? Yes
Model Application Form – Teacher – version 10 – April 2013
THE CATHOLIC EDUCATION SERVICE ©
No
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2. DETAILS OF APPLICANT’S PRESENT EMPLOYMENT
2.1
Are you presently employed?
Yes
No
If no, please proceed to the next section.
2.2
Details of Present Post
2.2.1
Role:
At
School/College
2.2.2
Address:
2.2.3
Telephone No.:
2.2.4
Local Authority:
2.2.5
Diocese:
2.2.6
Permanent:
2.2.7
Full time:
2.2.8
Date of Appointment:
2.2.9
Notice Required:
Temporary:
Part time:
Job Share:
2.2.10 Probationary Period/NQT Induction year completed? If so, please provide date:
2.2.11 Description of key duties/responsibilities (including subjects and key stages taught (if
applicable)):
2.3
Please provide the following information relating to present salary and scale:
2.3.1
Salary scale (e.g. Main/Upper/Leadership):
2.3.2
Group of School/Number on roll:
2.3.4
Additional Allowances (including Inner/Outer/Fringe London):
2.3.5
Gross annual salary:
2.3.3
Spine Point:
3. APPLICANT’S EMPLOYMENT HISTORY AND PROFESSIONAL
EXPERIENCE
Model Application Form – Teacher – version 10 – April 2013
THE CATHOLIC EDUCATION SERVICE ©
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Please complete in chronological order, starting with the most recent:
Full name and address of
Approx
Age
Post held and
school/
size of
range
responsibilities
institution (state whether
roll
taught
including
Nursery/
&
subjects and
Primary/
Single
key stages
Secondary/
sex/
taught
Comprehensive/
mixed
Selective etc)
(include local authority if
relevant)
Dates
employe
d
Month/
Year
From
To
-
-
-
-
-
-
4. OTHER EMPLOYMENT/WORK EXPERIENCE
Model Application Form – Teacher – version 10 – April 2013
THE CATHOLIC EDUCATION SERVICE ©
Reason
for
Leaving
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4.1
Please complete in chronological order, starting with the most recent:
Employment/Experie Employer/Location
Responsibilities
Dates
nce
employed
Month/
Year
From
To
-
-
-
-
-
-
-
Model Application Form – Teacher – version 10 – April 2013
THE CATHOLIC EDUCATION SERVICE ©
Reason for
Leaving
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4.2
If there are any periods of time that have not been accounted for in your application, for instance,
periods spent raising a family or of extended travel, please give details of them here with dates.
The information provided in this form must provide a complete chronology from the age of 16 –
please ensure that there are no gaps in the history of your education, employment and other
experience. Failure to provide a full account may lead to your application being rejected.
Dates (from – to)
-
Activity
-
-
-
Model Application Form – Teacher – version 10 – April 2013
THE CATHOLIC EDUCATION SERVICE ©
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5.
5.1
POST-11 EDUCATION AND TRAINING
Please complete in chronological order, starting with the most recent:
Full name and address of
establishment
Full time
or part
time
Dates
Attende
d
Month/
Year
Date of
Award
Awarding Body
&
Registration
No.
(if known)
Award
(Please state
the
classification/
grades as
appropriate)
From
To
Post Graduate Qualifications (please state if you hold the Catholic Certificate of Religious
Studies (or equivalent))
-
-
Higher Education Qualifications
-
-
School/college Qualifications
-
-
-
Model Application Form – Teacher – version 10 – April 2013
THE CATHOLIC EDUCATION SERVICE ©
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5.2
Continued Professional Development
Please list any courses you have completed and/or any professional development in which you have been
involved in the past 3 years which you consider relevant to this post (e.g. teaching courses, First Aid, ICT
etc).
Course Title
Course Provider
Length of
Dates
Award/Grade
Course
From / To
received (if
applicable)
6. PROFESSIONAL MEMBERSHIPS
Please list any relevant professional bodies of which you are a member:
7. INTERESTS AND HOBBIES
Please list your interests and hobbies outside of work:
8. SUPPORTING STATEMENT
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Please provide a written statement of no more than 1,300 words detailing why you believe your
experience, skills, personal qualities, training and/or education are relevant to your suitability for the post
advertised and how you meet the person specification. You should pay particular attention to the national
standards for the position for which you are applying.
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THE CATHOLIC EDUCATION SERVICE ©
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9. REFERENCES
9.1 Schools/Colleges of a Religious Character are permitted, where recruiting for Teaching posts, to
give preference to applicants who are practising Catholics and, therefore, one referee should be
your Parish Priest/the Priest of the Parish where you regularly worship. You are advised to read
the relevant section of the Notes to Applicants before completing this section.
Present School/Employer:
Name:
Address:
Designation (if applicable):
Telephone:
Email:
Other Professional (where you are not currently employed with children, this must be your
most recent school/college employer):
Name:
Address:
Designation (if applicable):
Telephone:
Email:
Parish Priest/Priest of the Parish where you regularly worship (or Additional Professional):
Name:
Address:
Designation (if applicable):
Telephone:
Email:
Notes:
(i)
We reserve the right to take up references with any previous employer.
Please advise if you do not want us to do so at this stage and provide reasons.
(ii) If any of your referees knew you by another name, please
specify that name(s) here:
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9.2
Are you (or your spouse/civil partner/partner) related by marriage, blood or as a co-habitee to any
member of the Governing Body or any current employees of the Governing Body?
Yes:
No:
If yes, please complete the following:
Name of Governing Body
Relationship to you
member/employee
10. DISCLOSURE OF CRIMINAL AND CHIILD PROTECTION MATTERS AND
DISCLOSURE AND BARRING SERVICE CHECKS
10.1 The Governing Body is obliged by law to operate a checking procedure for employees who have
substantial
access to children and young people.
Please confirm whether you have ever been the subject of any child protection concern either in your work
or personal life, or been the subject of, or involved in, any disciplinary action in relation thereto, including
any which is time expired.
Yes:
No:
If yes, please provide details:-
10.2
By checking the box below I hereby confirm that I am not disqualified from working with children
and/or have information held about me under section 142 Education Act 2002 (formerly known as
inclusion on the DfE List 99):
10.3
In the event of a successful application an offer of employment may be made to you which is
conditional upon receipt of satisfactory Disclosure and Barring Service Checks (“DBS Checks”)
(formerly CRB Check and ISA Check) in relation to criminal and child protection matters. Please
note that a conviction will not necessarily be a bar to obtaining employment.
By checking the box below you hereby consent to a DBS Check(s) being made to the Disclosure
and Barring Service (“DBS”):
11. REHABILITATION OF OFFENDERS ACT 1974
Model Application Form – Teacher – version 10 – April 2013
THE CATHOLIC EDUCATION SERVICE ©
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If you have been convicted of a criminal offence the details must be disclosed on the
separate document entitled “Rehabilitation of Offenders Act 1974 – Disclosure Form”
together with any cautions or bind-overs, pending criminal convictions, criminal actions
and/or court hearings against you. The Rehabilitation of Offenders Act 1974 – Disclosure
Form must be enclosed with your application in a sealed envelope marked “confidential”. If
you do not have any convictions, please complete the relevant section in the Disclosure
Form.
12. DATA PROTECTION ACT 1998
By checking the box below I hereby give my consent for personal information (any
information which may be considered Personal Data and/or Sensitive Data within the
meaning of the Data Protection Act 1998, which includes recruitment monitoring data)
provided as part of this application to be held on computer or other relevant filing systems
and to be shared with other accredited organisations or agencies in accordance with the
Data Protection Act 1998.
13. IMMIGRATION, ASYLUM AND NATIONALITY ACT 2006
The Governing Body will require you to provide documentary evidence of your entitlement to
undertake the position applied for and/or of your ongoing entitlement to live and work in the
United Kingdom in accordance with the Immigration, Asylum and Nationality Act 2006. More
information can be found in paragraph 18 of the Notes to Applicants. By checking the box
below you hereby confirm that you are legally entitled to work in the United Kingdom and that
you will provide documentary evidence of such entitlement when requested:
12.
DECLARATION
If you know that any of the information that you have given in this application form is false or
if you have knowingly omitted or concealed any relevant fact about your eligibility for
employment which comes to our attention then your application may be withdrawn from the
recruitment process.
Providing false information is an offence and may result in this application being rejected. If
such a discovery is made after you have been appointed then you may be liable to be
dismissed summarily. You may also be reported to the Teaching Agency (England only), the
GTC (Wales only) or the Police, if appropriate.
By signing below I hereby certify that all the information given by me both on this form and in
any supplementary pages and the supporting evidence provided, is correct to the best of my
knowledge and belief, that all the questions relating to me have been accurately and fully
answered and that I possess all the qualifications that I claim to hold.
I acknowledge that it is my responsibility as the applicant, if invited for interview, to disclose
information to the panel which may affect my suitability and/or eligibility to work with children
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and/or vulnerable adults
Signature:
Date:
(The post will be subject to the terms and conditions of the appropriate Catholic Education
Service model contract, a copy of which will be provided to you before interview if you are
shortlisted).
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Additional Pages
Name:
Date of Birth:
Position applied for:
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Additional Pages
Name:
Date of Birth:
Position applied for:
Model Application Form – Teacher – version 10 – April 2013
THE CATHOLIC EDUCATION SERVICE ©