Teaching Staff Application Form

For Office Use Only
Candidate No
Job Ref No
/

TEACHING STAFF APPLICATION FORM

Please complete all sections where applicable

APPLICATION FOR THE APPOINTMENT OF
Where did you see the vacancy?
PERSONAL DETAILS
Title / Forename(s) / Surname
National Insurance No. / DfES No. / Do you need a work permit to work in the United Kingdom?
Yes No
Date of Birth
Address for correspondence / Telephone Numbers:
Day
Evening
Mobile
Email
Postcode
Equal Opportunities
Enclosed with the application packis a copy of the College’s Equality Policy Statement.
Please tick the box below if you have a disability that the College should be aware of. This is so that we can make whatever arrangements are necessary if you are short listed to attend an interview.
I have a disability .
Please provide details of what special consideration you may require if invited for interview in the space below:
Disclosure Information
Do you have a criminal record not regarded as spent under the Rehabilitation of Offenders Act 1974?
(Please tick) Yes No (See last page of application form for information on the Rehabilitation of Offenders Act 1974).
If yes, please provide information in a sealed envelope.
Data Protection Declaration
I have read and understood Xaverian College’s Data Protection Statement.
All offers of employment are subject to satisfactory medical, criminal, immigration and qualification checks by the College.

THIS PAGE WILL BE REMOVED DURING THE SHORTLISTING PROCESS.

For Office Use Only
Date
Job Ref No
/

EQUALITY MONITORING FORM

Xaverian College is committed to promoting diversity and practising equality of opportunity. Our Equality and Diversity Policy is aimed at ensuring that all appointments are made solely on merit. In order to help the College monitor the effectiveness of this policy, all applicants for appointments are asked to complete this form.

The data given on this form will be used in accordance with the Data Protection Act 1998. It will be kept strictly confidential and used for monitoring purposes only.

Please return with your completed application form. The Equality Monitoring Form will only be seen by a member of the Human Resources Team and will be kept separate from the application form during the selection process.

First Name(s)
Surname
Gender / Male Female Non-binary Other Prefer not to say
Is your gender identity the same as the gender you were assigned at birth?
Yes No Prefer not to say
Ethnic Origin
White – English/Welsh/Scottish/Northern Irish/British / Mixed – any other
White – Irish / Asian or Asian British - Indian
White – Gypsy/Irish traveller / Asian or Asian British – Pakistani
White – any other / Asian or Asian British – Bangladeshi
Black or Black British - African / Asian or Asian British – Chinese
Black or Black British – Caribbean / Asian– any other
Black – any other / Other Ethnic Group - Arab
Mixed – White and Black Caribbean / Other Ethnic Group – any other
Mixed – White and Black African / Prefer not to say
Mixed – White and Asian
Disability
Do you regard yourself as being disabled? / Yes No Prefer not to say
If yes, please specify your disability below:
Blind/partially sighted / Needs personal care support
Deaf/hearing impairment / Unseen disability e.g. diabetes, epilepsy, asthma
Dyslexia / Wheelchair user/other mobility difficulties
Mental health disability / Other disability
Multiple disabilities / Do not wish to give information
Age
16-19 / 20-25 / 26-40
41-50 / 51-60 / 61 or over

Thank you for completing this form.

For Office Use Only
Candidate No
Job Ref No
EDUCATION AND TRAINING
(Successful candidates will be required to provide proof of qualifications)
Dates / School/College/University / Qualification (and awarding body) and levels achieved
BRIEF DETAILS OF OTHER COURSES AND AWARDS / DATES
EMPLOYMENT DETAILS
Present or most recent employment:
Name and Address of Employer / Post Title
Post Code / Start date / End date
Tel No / Salary Scale Point/Salary
Fax No / Period of Notice Required
Summary of Duties and Responsibilities
Reason for wishing to leave
Previous full-time/part-time/fractional teaching experience (most recent first)
Dates / Employer / Post Title/Duties / Salary / FT/PT
From / To
Reason for leaving:
Reason for leaving:
Reason for leaving:

Please continue on a separate sheetif necessary.

Hourly Paid Teaching Experience (e.g. supply teaching/evening classes)
OTHER EMPLOYMENT (Industrial, Commercial etc..)
Dates / Employer / Post Title/Duties / Salary
From / To
Reason for leaving:
Reason for leaving:
Reason for leaving:
Reason for leaving:
Reason for leaving:

Please continue on a separate sheet if necessary.

ADDITIONAL INFORMATION
Please indicate the reasons for your application and why you consider that your qualifications and experience are relevant to the post. If submitting a supporting statement please leave blank.
Continue on a separate sheet if necessary…….
Continue on a separate sheet if necessary…..
REFERENCES
Please provide the name, status and contact details of two referees; one of whom should be your current or immediate past employer.
Name of Referee
Post Title/Relationship to you
Address
Post Code
Tel No
Fax No
Email / Name of Referee
Post Title/Relationship to you
Address
Post Code
Tel No
Fax No
Email
Note: If you are shortlisted for interview your referees will be contacted.
DECLARATION
I declare that the information given in this application is, to the best of my knowledge, complete and correct. I also understand that any incorrect information renders me liable to dismissal if appointed. If submitting your application electronically you will be asked to sign your application form at interview if successfully shortlisted.
Signed:
Date:

Please return completed application form to:
Postal address
Human Resources
Xaverian College
Lower Park Road
Manchester
M14 5RB / Email address

NOTE: The college cannot accept responsibility for postage. Please ensure your application has full postage for guaranteed delivery.
Protection of children: Disclosure of criminal background of those with access to young people
Rehabilitation of Offenders Act (Exceptions) (Amendments) Order 1986
Rehabilitation of Offenders Act 1974
The Rehabilitation of Offenders Act 1974 provides that certain criminal convictions become “spent” after the passage of time, that is, the law will treat them for most purposes as if they had never happened and is not necessary to disclose them on application forms.
SENTENCE / BECOMES SPENT AFTER
Imprisonment of between 6 months and 2 ½ years / 10 years
Imprisonment of up to 6 months / 7 years
Borstal training / 7 years
A fine or sentence not otherwise covered in this table / 5 years
Absolute discharge / 6 months
Probation order, conditional discharge or bind over / 1 year (or until order expires, whichever is the longest)
Detention Centre order / 3 years
Remand home, attendance centre or approved school order / This period of the order + 1 year after the order expires
Hospital order under the Mental Health Act / The period of the order + 2 years after it expires
Cashiering, discharge with ignominy or dismissal from the Armed Forces / 10 years
Dismissal from the Armed Forces / 7 years
Detention / 5 years
NOTE - A sentence of more than 2 ½ years’ imprisonment can never become spent. It is the sentence imposed by the court that counts (even if it is a suspended sentence), not the time actually spent in prison.
However, the Rehabilitation of Offenders Act (Exceptions) (Amendments) Order 1986 contains certain classes of employment where a person can be asked to disclose spent convictions. The Act does not apply to the following job categories:

• finance – accountancy
• lecturer in a health-related or social work area who may have contact with patents and/or clients
• researcher in a health-related or social work area who may have contact with patients and/or clients
• lecturer whose work may bring him/her into contact with children, elderly, sick, disabled people or people who are vulnerable in other ways
• researcher whose work may bring him/her into contact with children, elderly, sick, disabled people or people who are vulnerable in other ways
• those working with children

The post for which you are now applying falls within that Order and you are therefore required to provide detail of any previous convictions whether or not they are spent.
Failure to disclose information concerning previous convictions may lead to dismissal or disciplinary action by the College. Any information given will be treated in strictest confidence and will be considered only in an application for posts to which the order applies.

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