Application Form
/ Head Teacher: Mr G T Burgess MA
Balsall Common Primary School Academy
(Lead School in the Central Schools Trust)
Balsall Street East
Balsall Common
CV7 7FS
Tel: 01676 532254
Fax: 01676 533314
E-mail:
Web Site: www.balsallcommonprimary.co.uk
This school has a responsibility for, and is committed to, safeguarding and promoting the welfare of children, young people and vulnerable adults, and requires all staff and volunteers to share this commitment.

Application for Employment (DBS)

Vacancy Details
Job Title: / Job Ref No:
Applicant No: / Closing Date:
Personal Details
Full Name:
Address:
Postcode:
Telephone Numbers: / Daytime: / Evening: / Mobile Number:
NI Number: / Email address:
Please indicate if you are happy to receive correspondence via your e-mail address, e.g. Invite to Interview Letter. / YES / NO
Are you currently, or have you previously been, employed by this organisation? / YES / NO
If ‘Yes’ please provide ‘from’ and ‘to’ dates and reasons for leaving (if applicable):
Date from: / Date to:
Reason for leaving (if applicable):
Are you related to a Councillor, Governor or employee of this organisation?
If ‘Yes’ please provide details below:
Name: / Relationship to you:
Please state the number of days illness or incapacity you have had in the last two years which caused you to be absent from work or study. Please give the reason and number of days for each separate absence:
Do you hold a current valid, full driving licence? / YES / NO / If yes, please state type (e.g. PSV, HGV1)
Disability
Do you consider yourself to have a disability within the terms of the Disability Discrimination Act 1995 (as amended)? / YES / NO

This organisation has made a commitment to improve the employment opportunities for people with disabilities and has, therefore, undertaken to guarantee to interview all applicants with a disability who meet the essential requirements for the job as stated in the person specification.

Please specify any arrangements we can make to assist you if you are invited to attend for interview/ assessment (e.g. wheelchair access, BSL interpreter or information in alternative format):
Present or Most Recent Employment
Name and Full Postal Address of Employer:
Job Title: / Salary:
Date from: / Date To: / Notice Period:
Reason for leaving:
Please provide brief details of duties and responsibilities:
Employment History
It is essential to include details of ALL employment, including any breaks in employment history and the reason for the break. References may be sought from your previous employers. Please indicate if you wish to be consulted before they are approached: / YES / NO
Name/Address/Tel. No. of Employer: / Dates (From/To) / Job Title and Salary / Reason for Leaving

Please continue on a separate sheet if necessary.

Relevant Qualifications and Education
Relevant Qualification / Result/Grade / Date Obtained

If you are invited to interview, you will be asked to bring your original Certificates with you.

Relevant Training
Date / Course Title / Organising Body
Membership of Relevant Professional Bodies
Name of Professional Body / Type of Membership / Date of Membership / Membership Number
Job Share
Please say if you wish to be considered for this position on a job share basis. All applications for job share will be considered on their merit. / YES / NO
Relevant Skills and Experience
Please demonstrate here how you meet the criteria on the person specification. You can include experience or knowledge you have gained through paid or unpaid work. This statement will be used to assess whether you will be invited to interview/assessment.
Relevant Skills and Experience (cont.)
References
Please provide details of two referees, one of whom must be your current or most recent employer. Family members may not be used as referees. Any offer of appointment will be subject to references which are satisfactory for our purposes.
First Reference (current or most recent employer)
Do you wish to be consulted before this referee is approached? / YES / NO
Referee name: / Job title:
Organisation:
Full Postal Address:
Telephone No: / Email address:
Relationship to you:
Second Reference
Do you wish to be consulted before this referee is approached? / YES / NO
Referee name: / Job title:
Organisation:
Full Postal Address:
Telephone No: / Email address:
Relationship to you:
Rehabilitation of Offenders
This post involves working with children, vulnerable adults or is a position of trust and is therefore exempt from the provisions of the Rehabilitation of Offenders Act 1974. You must, therefore, disclose details of cautions, reprimands, final warnings and convictions, including ‘spent’ convictions. Please note, however, the amendmentsto the Exceptions Order 1975 (2013) provide that certainspent convictions and cautions are 'protected' and are not subject to disclosure to employers, and cannot be taken intoaccount. Guidance and criteria on the filtering of these cautions and convictions can be found at the Disclosure and Barring Service website. Please note failure to disclose information (subject to the paragraph above) could result in disciplinary action or dismissal by Balsall Common Primary School.
Have you, at any time, received, or do you have pending, a caution, reprimand, final warning or conviction (not including those subject to the amendments in the Exceptions Order 1975 (2013))? / YES / NO
If ‘Yes’, please give full details below:
Declaration
I confirm that the information contained in this application is, to the best of my knowledge, correct. I understand that my application may be rejected or that I may be dismissed, without notice, for withholding or giving false information. I give my consent to the processing of data contained or referred to in this application in accordance with the Data Protection Act 1998 and subsequent legislation.
Signed:
Date:

BCPS Job Application Form Page 11 of 11

Recruitment Monitoring Form

Job Title:

/

Applicant number:

/

Job reference number:

/
This organisation is committed to equal opportunities in employment and service delivery, and the following information is, therefore, required to help us ensure that our services are accessible to all.
This information will be treated as confidential and will not be viewed by the selection panel during the selection process.
Personal Details
Title: Mr/Mrs/Miss/Ms / If other please state:
Initial(s): / First name(s):
Last name: / Previous surname:
Known as:
Place of birth:
Telephone Nos: / Daytime: / Evening: / Mobile Number:
Email address:
Full Postal Address:
Advertising origin
Where did you hear about this vacancy?
Gender
Male / Female
Age
Date of birth:
Ethnic Origin (Please indicate with a √ )
I would describe my Ethnic Origin as:
WHITE / British
Irish
Any other White background
MIXED / Caribbean
White and Black African
White and Asian
Any Other Mixed Background
ASIAN OR ASIAN BRITISH / Indian
Pakistani
Bangladeshi
Any Other Asian Background
BLACK OR BLACK BRITISH / Caribbean
African
Any Other Black Background
CHINESE OR OTHER ETHNIC GROUP / Chinese
Any Other Ethnic Group
Do Not Wish To Specify

BCPS Job Application Form Page 11 of 11

Disability
Do you consider yourself to have a disability within the terms of the Disability Discrimination Act 1995? Disability in this context is defined as any physical or mental impairment which has a substantial and long-term (over 12 months) adverse effect on your ability to carry out normal day-to-day activities. Or if you have been diagnosed with a condition such as HIV, cancer or Multiple Sclerosis, which is deemed to be covered from the point of diagnosis rather than from when the condition may affect ability to carry out normal day-to-day activities. / YES / NO
If yes, please indicate which category best describes your disability (please indicate with a √ ):
Visual Impairment
Hearing Impairment
Learning Disability
Physical Disability
Other

PLEASE POST OR EMAIL YOUR COMPLETED FORM TO:

Head Teacher: Mr G T Burgess MA

Balsall Common Primary School Academy

Balsall Street East

Balsall Common

CV7 7FS

E-mail: Susan Clinton

Notes of Guidance for Applicants

Thank you for your interest in this vacancy at Balsall Common Primary School. Please find enclosed an application form, job description and a person specification. You may also find additional information relating to the particular vacancy. Please read these notes carefully before you complete your application.

Completing the Form

It is important that you fully complete the application form as it will be used by the recruitment panel to decide whether you will be invited to the interview/assessment process. The panel will compare your application form against the criteria listed on the person specification to see if you have all the essential skills, experience, qualifications and knowledge for the role. Where there are a lot of candidates who meet the essential criteria, the desirable criteria will be used to reduce further the number of candidates taken forward to the interview/assessment process.

This form may be typed or written by hand. If you wish to send your information in a different format (e.g. a word processed document) this must be laid out in an identical format to the original application form. We do not accept curriculum vitae unless specifically stated in the advertisement.

If you are completing the application form by hand please write as clearly as possible using black ink to enable the form to be photocopied.

Before you fill in the form:

·  Read the job description and person specification carefully.

·  Read any instructions carefully

Relevant qualifications and training

When identifying qualifications, training and membership it is only necessary to provide details of those which are relevant to the position for which you are applying. The Person Specification will identify any qualifications required for the post so please use this as a guide to which qualifications you should include.

The job description should also be read in conjunction with this section as you may have had training which is relevant to the tasks identified for the role.

If invited for interview/assessment you will be asked to bring the original copies of your certificates with you.

Job Share

The application form asks that you identify whether you wish to be considered for the position on a job share basis. All applications for job share will be considered, however, it is important to note that your request to do so may not be accepted if it is not operationally possible for the role to function in this way.

Relevant Skills & Experience

This is the section where you must ‘sell’ yourself. All information provided within the application form is important to the selection panel but particularly the information you provide in this section. It will help to form the basis on whether or not you are selected to attend for interview/assessment.

Read the person specification and relate any experience to it. Ensure you mention any experience you have that is relevant to the job – whether from school or college, at home, in voluntary work, on work experience, through paid employment, or through your interests. If you do not have much work experience in an area, think about how you can tell an employer that you have the skills to do the job. For example, if you require report writing skills, you could explain how you researched a topic for your exam course work and had to write up a report of your findings. Also mention any skills you have which are required for this post. Again, use the person specification and job description to assist with this. If this person specification asks for ‘Experience of working with elderly people’, do not just type ‘I have experience of working with elderly people’. It is important to explain how you have gained this experience, e.g. ‘I have helped to care for my grandmother for three years. She lived in my home and I helped her to wash and dress each morning’.

References

All applications require two referees, one of whom must be current or most recent employer.

Personal references are only acceptable where applicants have never been employed.

Please note pre-prepared references are not acceptable.

Ensure people are happy to provide a reference for you before including them as referees on the form.

Rehabilitation of Offenders Act 1974

Please declare any unspent criminal convictions or cases pending against you. Please note if you declare any unspent criminal convictions this will not automatically disbar your application.

What is a Spent Conviction?

1.  Sentences of more than 2½ years can never become spent. Other sentences become spent after fixed periods from the date of conviction. For a custodial sentence, the length of time actually served is irrelevant since the rehabilitation period is decided by the original sentence and begins on the date of conviction.

2.  The length of a rehabilitation period depends on the sentence as outlined overleaf.

REHABILITATION PERIOD
SENTENCE / People aged 18+ when convicted / People under 18 when convicted
Prison (immediate or suspended sentence) or youth custody of more than 6 months and not exceeding 2½ years / 10 years / 5 years
Prison (immediate or suspended sentence) or youth custody 6 months or less / 7 years / 3½ years
Fire/Community Service Order/Supervised Attendance Order / 5 years / 2½ years
Absolute discharge/Admonished / 6 months / 6 months
Probation after 5 February 1995 / 5 years / 2½ years
There are 2 sentences for people under 21 for which there is no variation in the rehabilitation period according to age when convicted. These are:
Borstal (replaced by youth custody in May 1983) / 7 years
Detention of 6 months to 2½ years / 5 years
Detention of under 6 months / 3 years
SENTENCE / REHABILITATION PERIOD
Probation before 5 February 1995, Supervision Order, Conditional Discharge, Bind-over or Hospital Order under the Mental Health Act / 1 year, or until the order expires (whichever is longer)
Attendance Centre Orders / 1 year after the order expires
Orders imposing a disqualification, disability or prohibition / Until the Order expires

If the post you are applying for is exempt from the Rehabilitation of Offenders Act 1974 (i.e. requires a Criminal Records Bureau check) you are required to declare any criminal convictions whether spent or unspent. If your application is successful, a provisional job offer will be made to you subject to the Criminal Records Disclosure.