The Wyvern School - ApplicationForm

TeachingPosts

Confidential

Posttitle:Closing Date:13th May 2013

Thisformisalsoavailableinalternativeformats(computerdisk,audiotapeandBraille). If you require alternative formats, please telephone: 01233 621468.

Pleasecompleteusingblackinkortype.

Thisisyouropportunitytotellusasmuchaspossibleaboutyourselfandwillhelpusmakeafairdecisioninthe selectionprocess.Pleaserefercarefullytotheinformationyouhavebeenprovidedforthispost.

Pleaseensureyou complete ALL sections of the application form. Your application will be treated in the strictest confidence.

PART1: PERSONAL DETAILS

Name: / PreviousSurname(s):
Address: / Alternativeaddress:
Postcode: / Postcode:
Telephone–Home: / Mobile:
Work: / Emailaddress:
DfEsnumber:/
NationalInsuranceNumber
(YoucanobtainthisinformationfromtheDepartmentofSocialSecurity)

General

HealthDeclaration

Doyouconsideryourselftobeingoodhealth? IfNO,pleaseprovidedetails

SuperannuationScheme

DoyoucontributetotheTeacher’sSuperannuationScheme?

Ifyoucontributetoanotherschemepleaseprovidedetails:

HaveyouelectedtopaySuperannuationcontributionsforparttimeteaching?

YesNo

YesNo

YesNo

Disclosureofrelationship

Areyourelatedtoanymemberoftheschool stafforamemberoftheSchoolGoverningBody?

YesNo(IfYES,pleaseprovidedetails)

Howdidyoubecomeawareofthisvacancy?

Media:Date:Reference:

Pleaseindicatetwopeoplewhocanprovidereferences–oneofwhomshouldbeyourpresent/mostrecent employer.StudentsshouldincludetheirUniversity/Collegetutor.

Referenceswillbetakenupbeforeanofferofemploymentismadeandmaybetakenuppriortointerview.

1. Name: / 2. Name:
Address: / Address:
Tel.No.: / Tel.No.:
Email: / Email:
Occupation: / Occupation:

PART 2 : COMPETENCY

EducationandTraining

Documented proof ofqualificationswillberequiredpriortoanappointment.

a)TrainingasaTeacher

NameofTeacherTrainingInstitute
Dates / From: / To:
Qualificationobtained
Subjects–MainandSubsidiary
AgeRange/KeyStage
Otherspecialinterests

b)University,College,etc(otherthaninitialteachertraining)

NameofInstitution(s) / Datefrom / Dateto / FullorPartTime
1. / MonthYear / MonthYear
2.
Degree/Diploma/Title / Subjects / HonsorPassGrade / DateofAward
1. / MonthYear / MonthYear
2.

c)SecondaryEducation

NameofSchool(s)andarea / 1.
2.
Qualificationsgained
(Givesubjects,grades,dates)
‘O’Levels,GCSE(orequivalent)
‘A’Levels(orequivalent)

In-ServiceTrainingandDevelopment

Pleasegivedetailsofrelevantcoursesandtrainingundertakeninthelastfiveyears.

Datesandduration / TitleofCourse/Trainingincl.
HomeStudyDistanceLearning / NameofProvidere.g.
LEA,Collegeetc. / Qualification
obtained(ifany)

EmploymentHistory

Pleasegivedetailsofalljobsheldaftertheageof18,includingparttimeandunpaidwork,startingwithyourcurrent

ormostrecentemployer.Pleaseexplainanygaps.

Whengivingdetailsofschoolemploymentpleaseincludetheagerange,approximateschoolrollnumberandschool typei.e.maintained,independent,foundation.

(Continueonaseparatesheetifnecessarygivingpagenumberandtitleheading)

Employernameanddetails:
Job Title:
Dates: / FullorPartTime: / Salaryuponleaving
(andTLRpayments):
Reasonforleaving:
Employernameanddetails:
Job Title:
Dates: / FullorPartTime: / Salaryuponleaving
(andTLRpayments):
Reasonforleaving:
Employernameanddetails:
Job Title:
Dates: / FullorPartTime: / Salaryuponleaving
(andTLRpayments):
Reasonforleaving:

OtherSkillsandInterests

Pleaseincludelanguages(spoken/written),computers,etc.Pleaseprovidedetailsofanycommunityorvoluntary workexperience.

ApplicantStatement

Inthissectionyouareaskedtooutlinehowyourknowledge,skillsandexperiencesmeetthecompetenciesrequired

forthispost(wheresetoutinthepersonalspecification).Remembertoconsiderexperienceinpreviousemployment and relevant experience outside of paid work e.g. that gained at home, through the community or through leisure/collegeactivities.

(Continueonaseparatesheetifnecessarygivingpagenumberandtitleheading)

Protectionofchildren

Disclosureofcriminalbackgroundisrequiredofthosewithsubstantialaccesstochildren.

Youarerequiredtogivedetailsasthispost,forwhichyouareapplying,isexemptfromtheprovisionsofSection4(2)

of the Rehabilitation of Offenders Act 1974 by virtue of the Rehabilitation of Offenders Act 1974 (Exceptions) (Amendment) order 1986. A subsequent offer of appointment will be dependent upon the completion of a satisfactoryEnhancedDisclosure and Barring Service check.

Haveyoueverbeenconvictedorcautionedofacriminaloffence?

(IfYES,pleaseprovidedetailsoftheOffence,theSentenceandtheDate)

YesNo

ArethereanyrestrictionstoyourresidenceintheUKwhich

mightaffectyourrighttotakeupemploymentintheUK?

(IfYES,pleaseprovidedetails)

YesNo

Ifyouaresuccessfulinyourapplication,wouldyourequirea

workpermitpriortotakingupemployment?YesNo

DataProtectionStatement

‘IherebygivemyconsentforThe Wyvern School toprocessandretainonfileinformation(includinghealthandethnic
data)containedonthisformandinaccompanyingdocuments.Thisisrequiredforrecruitmentpurposes,thepayment
ofstaffandthe preventionanddetectionoffraud.Allinformationwillbedealtwithinaccordancewithdataprotectionlegislation.’

Declaration

I declare that the information I have given in this application is accurate and true. I understand that providing misleadingorfalseinformationwilldisqualifymefromappointmentOR,ifappointed,mayresultinmydismissal.

SignatureDate

Pleasereturnyourcompletedapplicationformto: Mr D Spencer

Headteacher

The Wyvern School

Great Chart Bypass

Ashford

Kent

TN23 4ER

PART 3 : EQUAL OPPORTUNITIES MONITORING

ThissectionoftheformisCONFIDENTIALandwillbedetachedfromyourapplicationpriortointerview.

The Wyvern Schoolrecognisesandactivelypromotesthebenefitsofadiverseworkforceandiscommittedto treatingallemployeeswithdignityandrespectregardlessofrace,gender,disability,age,sexualorientation, religionorbelief.Wethereforewelcomeapplicationsfromallsectionsofthecommunity.

EthnicGroup (TheseareapprovedbythecommissionforRacialEquality)

White

BritishIrishAnyotherWhitebackground*

Mixed

WhiteBlackCaribbeanWhiteBlackAfricanWhiteAsianAnyotherMixedbackground*

BlackorBlackBritish

CaribbeanAfricanAnyotherBlackbackground*

AsianorAsianBritish

IndianPakistaniBangladeshiAnyotherAsianbackground*

ChineseorOtherEthnicGroup

ChineseOtherEthnicGroup*

*Pleasespecify

Gender

MaleFemale

DateofBirth

Ifyouwishyoumaydiscloseinformationaboutyourselfinthissectionaboutyour:

Religion

SexualOrientation

DisabilityStatement

The Wyvern Schoolaimstobeafairemployerandiscommittedtoequalopportunityfordisabledpeople. Applicationsfromdisabledpeoplearewelcome.Ifyouareofferedaninterview,wehaveapolicyofproviding appropriate access and equipment to ensure that disabled people are considered on an equal basis.

Ifyouwouldlikeanyfurtherassistanceoradviceaboutthisapplicationwewilltrytohelp.

Pleaseanswerthefollowingquestions:

1. Doyouconsideryourselftobedisabled?

IfYES,doyouconsideryourselftobedisabledunderthetermsof theDisabilityDiscriminationAct?

YesNo

YesNo

TheDisabilityDiscriminationAct1995definesdisabilityas‘aphysicalormentalimpairmentwhichhasasubstantial andlong-termadverseaffectonanindividual’sabilitytocarryoutnormalday-to-dayactivities.’

2. Isthereanythingyouwouldparticularlyliketotellusaboutyourdisability?

3. Doyouwishustotrytoarrangeforanyother assistance ifyouarecalledforinterview?

The information you have given will be treated as confidential and is necessary to enable us to provide appropriateadjustmentsandfacilities.Thankyouforprovidingthisinformation.