If completing this form by hand, please use block capitals. Do not write in shaded areas.

Post applied for
Please also indicate whether you are applying for a full or part-time position
Title:Dr, Mr, Mrs, Ms or other / Surname:
First and middle name/s:
Underline the name by which you are known / Former surnames:
Home Address
Telephone / Home:
Work:
Mobile:
E-mail
N.I. number
Education and training
List details of your education since secondary school, starting with the most recent education and training
From / To / Establishment - most recent first / Qualifications obtained and grade
Employment
Please supply a full history (with start and end dates) of all employment, self-employment and any periods of unemployment since leaving secondary education, starting with your most recent employment and working backwards. Provide where appropriate explanations for any periods not in employment, self-employment or further education/ training and in each case any reasons for leaving employment. (Please use separate sheet if necessary).
From / To / Employer - most recent first / Position
Present post
Please provide this information in relation to your present or last employment
Teaching subject(s)
Reason for leaving
Deadline date for notice to be given / Earliest start date (if appointed) / Current salary
DfE number
Are you registered with the GTC?
References
Provide details of at least two professional referees (one should be your current or most recentemployer).
** Please note the school may seek references prior to interview unless you advise us otherwise**

Referee 1

Name:
Position:
Company/school:
Address:
Telephone No:
E-mail address:
Your connection with the above person:

Referee 2

Name:
Position:
Company/school:
Address:
Telephone No:
E-mail address:
Your connection with the above person:

Work Status and Adjustment Requirements

1. Do you have the right to work in the UK? / Yes No
2. If the answer to 1. above is ‘Yes’, please describe any current restrictions on your stay or on your right to work in the UK in the adjacent box.
Do not leave blank but state ‘none’ if appropriate.
3. Please outline any reasonable adjustments that could be made to assist you during the selection process.
How did you hear about this job vacancy?
Told about the vacancy by a friend/colleague
Saw advertisement on an on-line jobsite / Please specify:
Saw advertisement in local paper / Please specify:
Referred by a recruitment agency / Please specify:
Other / Please specify:

Disclosure and Barring Service (DBS) and overseas police checks

St Paul’s is a “registered body” under the Police Act 1997 because employment here involves access to children under the age of 18. This post will require an enhanced DBS check from the Disclosure and Barring Service (formerly Criminal Records Bureau) before we can confirm an offer of employment. You will need to apply for a new disclosure, even if you already hold one unless you are subscribed to the DBS Update Service. Former members of staff who are not on the Update Service who re-join us also require fresh disclosures, unless less than three months have passed between their leaving and their re-employment date. If you have lived or worked abroad you will also need to provide appropriate paperwork, such as a police certificate of good conduct, from the countries you have lived in.

Declaration

I am aware that the post for which I am applying is exempt from the Rehabilitation of Offenders Act 1974 and therefore that any convictions, cautions, reprimands or final warnings which would not be filtered in line with current guidance must be declared. I have not been disqualified from working with children, am not named on DfE List 99 or the Protection of Children Act List, I am not subject to any sanctions imposed by a regulatory body (e.g. the General Teaching Council) and either

(please tick as appropriate)

I have no convictions, cautions, reprimands or final warnings

OR

I have attached details of any convictions, cautions, reprimands or final warnings in a sealed envelope marked confidential.

Signed ……………………………………………………………. Date………………………………

Please return this form with your CV and cover letter to: Alice Matcham at RSAcademics on