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Teaching Application Form

Position Applied For

I am applying for the position of

General Information

Title* First name* Middle name(s) Last name* Previous name Mobile/Cell phone number* Home telephone Email address* National Insurance Number*

UK Work Declaration*I am qualified to work in the UKI am NOT qualified to work in the UK

Are you applying for this vacancy as a job sharer*YesNo

Address

Address (line 1)* Address (line 2) Town/City* Postcode* Country*

Employment History

Present or Most recent Employment

	Preset Employer	Previous Employer #1	Previous Employer #2	Previous Employer #3
Employer’s Name
Employer’s Address
Nature of Business
Dates of appointment
Reasons for leaving
Job Title and summary of main duties
Are you still employed by this organisation?
Salary scale and current salary
Grade and details of allowance
Notice required

Previous Non-teaching Employment

Please summarise your non-teaching employment history since leaving full-time education, paid or unpaid, or working in a voluntary organisation or agency, full or part-time. Start with the most recent.

	1	2	3	4
Employer’s Name
Employer’s Address
Dates of appointment
Job Title and summary of main duties
Reasons for leaving

Do you have any gaps in your employment/education history?
Schools may not consider your job applications if you don’t explain any gaps in your employment/education history.

If necessary please upload additional information or supporting evidence using the button below. No file chosen

Professional Details

DfE number*

I am a member of the Teachers' Pension Scheme*YesNo

Do you hold Qualified Teacher Status?
If YES, please give date of award
If you are a Newly Qualified Teacher, please detail any teaching experience gained through teaching placements.
If you are a Qualified Teacher, please complete Section B only.

Do you hold a National Professional Qualification for Headship (NPQH)*YesNo

Teaching Information

Teaching Staff Information
	Start Date to End Date	Names of Placement Schools	Primary/Secondary/Special	Age of Children Taught	Subjects Taught
1
2
3
4
5
6
7

Please list any forms of Professional Development undertaken

Education

Higher Education
	Degree/Course	University/College Level	Qualification	Years attended
1
2
3

Schools attended
	School	Dates attended
1
2
3
4

A-Levels or equivalent
	Subject	Exam	Grade
1
2
3
4
5
6

GCSEs or equivalent
	Subject	Exam	Grade
1
2
3
4
5
6
7
8
9
10

Please upload a supporting statement for this role* No file chosen Additional skills Full driving licence*

Referees

Current or most recent employer

May be contacted prior to interview?* Title Name Position held Organisation Capacity Address Email Address Telephone Number

Second referee

May be contacted prior to interview?* May be contacted for interview* Title name Position Held Organisation Capacity Address Email Address Telephone Number

Declarations

Any convictions, cautions, reprimands or final warnings, whether in the United Kingdom or in another country? These should exclude those defined as 'protected' by the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (as amended in 2013). For more guidance, please visit www.gov.uk.* Are you included in any list of people barred from working with children by the DBS or the NCTL* DBS Update Service registration number* Restrictions on being a resident or being employed in the UK? If yes, please provide details.* Lived outside the UK for more than three months in the past five years. If yes, please provide details. Please specify which countries and the month and year those stays started and ended.*

Job-specific questions

Details of relations to any current employees, pupils or governors*

Confirm data to be accurate

I certify to the best of my knowledge and belief the information given in this application is true and accurate. I understand that if the information is false or misleading it will disqualify me from my appointment or after appointment could lead to a disciplinary action or dismissal. I acknowledge that where this form is submitted electronically and without a signature, electronic receipt of this form by the employer will be deemed equivalent to submission of a signed version and will constitute confirmation of the declaration.

User Declaration*I agree to this declaration

Equal Opportunities details

Nationality Cultural/Ethnic Background Date of Birth

Gender*MaleFemalePrefer not to say

Sexual Orientation Religion/Belief

Do you consider yourself to be disabled?*YesNo

Special Arrangements Required

Please note: The Equality Act 2010 defines a person as having a disability if she/he has a physical or mental impairment that has a ‘substantial’ and ‘long-term’ negative effect on his/her ability to do normal daily activities.