1

To be completed and returned to: / /

For Office Use Only

Received: ______
Acknowledged: ______
Reports: ______
The Authority is an Equal Opportunities Employer
(The Policy Document is available on request)

EDUCATION COMMITTEE

HEADTEACHER/DEPUTY HEADTEACHER

Application for appointment as Headteacher/Deputy Headteacher at
School:
Post Reference:
(Applicants are requested to complete this form in BLOCK CAPITALS and in BLACK INK)
1 /
Surname
/ Initials
Home Address
Post Code / Telephone No.
Email Address / Mobile Telephone No.
DES Registration No. / National Insurance No.
Registered with the General Teaching Council for Wales or England / Yes / No
2 / Present Post
Name of School
Group of School
Present Status and Salary
(ie. Headteacher/Deputy Headteacher/Assistant Teacher etc. with scale and whether or not acting)
Salary £ / pa / Scale
Date of taking up appointment
State whether permanent or temporary
3 / Qualifications(please give the fullest possible details, including subject, class and division of all awards)
Qualifications, Degrees, Teaching Diplomas/Certificates obtained / Particulars of Establishment
(excluding schools) attended with dates / Date
4 /
Research
Outline the nature of any research undertaken, publications etc.
5 /
Previous Teaching Appointments
Designation of Post (with salary grade) / Name and Address of School/Institution / Primary, Secondary or FE / Name of Employing Authority / Duration of Employment
From / To / Total
Yrs / Mths
6 / In-Service Training Outline of courses attended during the last three years:
Nature of Course / Organising Body / Date / Duration of Course
7 / Relevant Experience other than Teaching(ie. Administrative, Executive)
Designation of Post / Nature of Duties / Period of Employment
From / To
8 /
Car Owners:
a)Are you a car owner / Yes / No
b)Do you possess a valid Driving Licence / Yes / No
9 /
A Confidential Report one of which will be obtained from your present or last employer, where appropriate
Name: / Name:
Address: / Address:
Tel. No. / Fax No. / Tel. No. / Fax No.
10 /
Canvassing
Applicants are required to state below whether they are related to members of the City and County of Swansea, of the Governing Body, or senior members of staff of the School/College.
Canvassing, whether directly or indirectly, will result in disqualification.
11 / Becauseofthenatureoftheworkinvolved,thepostyouareapplyingforiscoveredbythe RehabilitationofOffendersAct1974(Exceptions)Order1975(as amended in 2013).
Providingfalseinformationisanoffencewhichcouldresultinyourapplicationbeingrejected orsummarydismissalifyouhavealreadytakenupaposition.Themattercouldbereported tothePolice,andifyouarearegisteredworker,therelevantregulatorybodywillbenotified.
Doyouhaveanyconvictions,cautions, reprimands or final warnings which would not be filtered in line with current guidance? The DBS filtering guidance is available on the Home Office Website – Yes/No
If yes, please give further details:
______
______
______
Pleaseconfirmthatyouarenotoneitherofthetwobarredlists(Adult'sListorChildren's List)administeredbytheDisclosureandBarringService,arenotsubjecttosanctions imposedbyaregulatorybody,suchastheEducation Workforce Council,the GeneralMedicalCouncilortheNursingandMidwiferyCouncil.
Are you included on either of the barred lists stated? Yes/No
Do you have any sanctions imposed? Yes/No
.

LETTER OF APPLICATION

Applicants are invited to submit a letter below in support of their application. The letter should, with respect to the post applied for, comment on qualifications obtained since qualifying as a teacher, and also interpret the applicant’s views on educational principles, organisations and curriculum. Additional paper can be used if so wished.
CONFIDENTIAL
12 /
Classification of Employees
The City and County of Swansea is committed to an active Equal Opportunities policy. To assist the Council in monitoring the effectiveness of this policy, it would be helpful if you would complete the following. All information given will be treated in the strictest confidence.
Section a
/
Ethnic Origin
I consider my ethnic origin as (Please tick () appropriate box):
a / Black-African
b / Black-British
c / Black-Caribbean
d / Black-Other*
/ e / White-EuropeanUK
f / White-European Other
g / White-Other
h / Indian
i / Pakistani
/ j / Bangladeshi
/ k / Chinese
z / Other* (Please specify below)
*Other
Section b
/
Nationality
What nationality do you consider yourself to be:
Section c
/
Sex
My sex is (Please tick () appropriate box): / Male / Female
Section d
/
Age
My date of birth is:

Section e

/

Registered Disabled Persons

Are you registered disabled? (Please tick () appropriate box): / Yes / No
If Yes, please give registration number:

Additional Information

How did you find out about the vacancy, eg. Times Educational Supplement, Internal Bulletin etc?
Surname: / Maiden Name:
Forename(s):

Your privacy

Swansea Council is the data controller for the personal information you provide here. We will use the information we collect from this form, and from the supporting evidence you provide, to process your application for employment. Should you be successful in your application, we will also use this information to fulfil certain legal obligations and administer any service or benefit that we are responsible for as part of your employment eg statistical information and reporting.

We may check information provided by you, or other information about you provided by a third party, against other information we hold. We may also contact third parties to verify the accuracy of the information. For example, we may contact your previous employer with specific questions about your employment with them. We will only do this to prevent or detect fraud, as we are permitted to do by law.

Data protection law describes the legal basis for our processing of your data as one based on the pursuit of our legitimate interests. For further information about how Swansea Council uses your personal data, including your rights as a data subject, please see our corporate privacy statement at our website.