Children, Schools and Families
Application Form
CONFIDENTIAL
APPLICATION DETAILS
Position Applied for
Please note - the boxes will expand as you type in your details
PERSONAL DETAILS
Last Name: Title: First Names:
Previous Name(s):
Home Address:
Home Tel no: Mobile no:
E-mail:
The following section is only to be completed by Teaching Staff
DfE number Are you a Newly Qualified Yes/No
Teacher?
Do you hold Qualified Teacher Status? Yes/No Date Awarded:
Do you hold Qualified teacher Status Learning & Skills (QTLS) Yes/No Date Awarded
EDUCATION, QUALIFICATIONS AND TRAINING
Please provide details of education from the age of 11 years onwards
Original Certificates will be required prior to commencement
Secondary School/College Full or Qualifications attained /to be Grades Year taken/
Part-time taken. Subjects Attaine to be taken
d
Higher Education Institutions Dates Full or Qualifications attained / to Grade Year taken/
be
From To Part-time taken. Subjects Attaine to be taken
d
In-Service Education, Courses and Training (over last 3 years) – Please continue on a separate sheet
Dates and Duration Title of Course/Training Name of Provider (eg LA, College) Qualification (if any)
ELIGIBILITY TO WORK IN THE UK
National Insurance number:
Do you have the right to work in the United Kingdom?
Do you require a work permit?
CURRENT OR MOST RECENT EMPLOYMENT
Period of Service
Employer Address Position From To
held/Responsibilities and
achievements
D M Y D M Y
PREVIOUS EMPLOYMENT
Details of all other paid or unpaid, employment or experience. It is important that you include periods of breaks in
employment since leaving school. Please give details of these periods and your activities during these times, these
might include: career breaks to raise a family, travel, voluntary work, training, long periods of sickness,
unemployment, self employed. Evidence may be required.
Period of Service
Employer Address Position From To
held/Responsibilities and
achievements
D M Y D M Y
OTHER WORK EXPERIENCES (including career breaks, voluntary paid or unpaid work)
Details of all other paid or unpaid, employment or experience. It is important that you include periods of breaks in
employment since leaving school. Please give details of these periods and your activities during these times, these
might include: career breaks to raise a family, travel, voluntary work, training, long periods of sickness,
unemployment, self employed. Evidence may be required.
Period of Service
Employer Position held From To
D M Y D M Y
SUPPORTING STATEMENT
Please tell us how your experiences, abilities, skills and knowledge meet each of the points on the Person Specification. We
need to have this information in order to consider your application.
You may find it helpful to refer to each point of the Person Specification to help you complete this part of the application
form.
Please consider all your experience whether paid or unpaid. Give examples (where possible) in support of your application.
NB. The box will expand as you type in your statement
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PROTECTION OF CHILDREN (Rehabilitation of Offenders Act 1974)
We are committed to safeguarding and promoting the welfare of children and young people and expect all staff and
volunteers to share this commitment. All our posts are subject to a satisfactory Disclosure and Barring Service (DBS)
check.
The job for which you are applying has substantial opportunity for access to children.
This post is exempt from the Rehabilitation of Offenders Act 1974 and therefore applicants are required to declare any
convictions, cautions, reprimands and final warnings that are not protected (i.e. that are not filtered out) as defined by the
Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (as amended in 2013). For further information please refer to
https://www.gov.uk/government/publications/new-guidance-on-the-rehabilitation-of-offenders-act-1974
We recognise the contribution that ex-offenders can make as employees and volunteers and welcome applications from them. A
person’s criminal record will not, in itself, debar that person from being appointed to this post. Any information given will be
treated in the strictest confidence. Suitable applicants will not be refused posts because of offences which are not relevant to, and
do not place them at or make them a risk in, the role for which they are applying.
All cases will be examined on an individual basis and will take the following into consideration:
· Whether the conviction is relevant to the position applied for.
· The seriousness of any offence revealed.
· The age of the applicant at the time of the offence(s).
· The length of time since the offence(s) occurred.
· Whether the applicant has a pattern of offending behaviour.
· The circumstances surrounding the offence(s), and the explanation(s) offered by the person concerned.
· Whether the applicant's circumstances have changed since the offending behaviour.
Please be aware that failure to disclose all convictions, cautions, reprimands or final warnings that are not protected could result
in any offer of employment being withdrawn or, if appointed, disciplinary action which may result in dismissal.
Do you have any convictions, cautions, reprimands or final warnings which are not protected as defined by the Rehabilitation of
Offenders Act 1974 (Exceptions) Order 1975 (as amended in 2013)?
Date: Offence:
Sentence:
Please note: All information we receive will be treated as confidential.
Have you ever been disqualified from working with children or vulnerable adults? YES/NO
It is a criminal offence for barred individuals to seek, or to undertake, work with children. If you have answered ‘Yes’ to either of
the above and are called to interview, please provide further further details on a seperte sheet in a sealed envelope marked
‘CONFIDENTIAL’
APPLICANTS FROM OUTSIDE THE UK
Applicants who have lived and /or worked outside of the UK need to provide an overseas criminal records check and/or
certificate of good conduct from their home country. Guidance on the process will be provided for the appointed candidate.
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REFEREES
If you are selected for an interview we will obtain references prior to interview. Due to safeguarding requirements, we
reserve the right to contact any past employer for a reference. Your first referee must be your current or last employer
if you have one. If you are a school/college leaver give the details of your Headteacher or Tutor. Family members and
friends will not be accepted as a referee.
1) Name …………………………….. 2) Name ………………………………………
Address …………………………….. Address ………………………………………
…………………………….. ………………………………………
……………………………… ………………………………………
Email …………………………….... Email ………………………………………
Tel no ……………………………… Tel no ………………………………………
How is this referee How is this referee
known to you? known to you?
GENERAL INFORMATION
When would you be free to commence duty?
POLITICAL RESTRICTIONS
Some posts are also subject to political restrictions under the provisions of the Local Government and Housing Act 1989. If this
post is subject to these conditions, further details will be made avaible to you.
DISCLOSURE OF RELATIONSHIP
Are you related to, or have a close personal relationship with any Merton Councillor, Council officer, School governor or member
of staff at this school?
Yes No If yes, state the name, relationship and position held
EQUALITY ACT 2010
The Equality Act 2010 protects people with disabilities from unlawful discrimination. If you tell us that you have a
disability we will make reasonable adjustments to your working environment and to your work arrangements and
practices, if it is reasonable for us to do so.
Do you consider yourself to have a disability?
If yes, please describe your disability:
If you are invited to an interview and you believe that we should make
reasonable adjustments for you please describe what will be required:
GENERAL DATA PROTECTION REGULATIONS 2018
The School’s Privacy Notice is in line with the General Data Protection Regulations 2018.
I declare that the information I have given on this form and any other accompanying documents is correct.
I understand that any ommisions or false or misleading information provided on this form could result in my
appointment being rejected or, in the event of employment being obtained, may result in disciplinary action being
taken up to and including summary dismissal. It could also result in a referral to the police.
I understand my application form will be retained on file and give my consent for the personal data supplied to be
used for the purposes of recruitment and selection.
Name:
Date:
By providing my name or email address, this means that I have read, understood and agreed to the above
