teacher of technology
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CHURCH OF ENGLAND - DIOCESE OF SOUTHWARK
TEACHER OF TECHNOLOGY APPLICATION
CONFIDENTIAL
SOUTHWARK DIOCESAN
BOARD of
EDUCATION
NAME OF SCHOOL: CHRIST’S SCHOOL
POST APPLIED FOR: TECHNOLOGY
Closing date for completed form: 9am, Monday 11th May 2015
Return form to: Mrs J Ralph at: jralphchrists!richmond!sch!u" Christ#s school$ueens RoadRichmond
%urrey &'10 ()'
to *hom all +ueries should e addressed
-lease state *here yousa* the ad.ertisementfor this post:
1 APPLICANT'S PERSONAL DETAILS
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2 TEACHER STATUS
1 %8 &eacher 4pplication orm January 2015
mailto:[email protected]:[email protected]:[email protected]
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8o you ha.e $uali
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Havi! "#a$ % () $#*+"i,%i( a$ ,#"*( *,#+i+a%i(. ,/#a*# *a0 &0 0( ##/ 0( a"#*i%a)/# (" %&i* ,(*%. a$$"#**i! #a+& ( % ,#"*( *,#+i+a%i( +"i%#"ia "#4i"#$ a$ a0a$$i%i(a/ i("5a%i( &i+& 0( %&i6 (/$ )# *#/ %( %&i* ,(*%7
8 PRESENT OR MOST RECENT EMPLOYMENT
@ %8 &eacher 4pplication orm January 2015
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34M 7 %C)77 438 M-7;R: %C)77 488R%%:
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PRE;IOUS EMPLOYMENT ,/ai a0 !a,* i#5,/(05#% a$ +(5,/#%# a// +(/5*?
%chool, college or otheremployer
&ype A statusofestalishment
4gerangeand roll>appro?
&itle of post >includespecial responsiilities?
8ates ofemploymentand reason>s?for lea.ing
D %8 &eacher 4pplication orm January 2015
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@ EDUCATION AND ACADEMIC UALIFICATIONS
%choolEcollegeEuni.ersity rom &o %ujectsE$ualipost 1(?
)igher ducation
urther postgraduate+ualiincluding -BC?
B IN-SER;ICE TRAINING UNDERTAKEN DURING THE PAST 3 YEARS RELE;ANT TO THISAPPLICATION
Course title -ro.ider 8ates A durationof course
4*ard >if any?
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OTHER PAIDUNPAID WORK EPERIENCE ,/ai a0 !a,* i #5,/(05#%?
mployer rom &o 3ature of 7ccupation and reasons forlea.ing
DETAILS OF OTHER ACTI;ITIES. SKILLS AND INTERESTS RELE;ANT TO THIS POST
( %8 &eacher 4pplication orm January 2015
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1 RELIGIOUS AFFILIATION > Answering ‘None’ will not disqualify you from being selected forinterview)
F %8 &eacher 4pplication orm January 2015
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8etails of your +uali
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12 DECLARATION Y APPLICANT
DISCLOSURE OF CRIMINAL CON;ICTIONS
9 %8 &eacher 4pplication orm January 2015
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urther to the recent changes >May 201@? to the 8isclosure and arring %er.ice, cautions andcon.ictions on the Criminal Record Chec" *ill e *here indi.idual o.er 1G at the time of caution?
- Cautions gi.en less than 2 years ago >*here indi.idual under 1G at the time of caution?
- Con.ictions relating to an oHence from a list agreed y -arliament I %ee *esite ao.e
- 'here the indi.idual has more than one con.iction, i+/$# a// +(vi+%i(*
- Con.ictions that resulted in a custodial sentence >regardless of *hether ser.ed?
- Con.ictions gi.en less than 11 years ago >*here indi.idual o.er 1G at the time of con.iction?
-Con.ictions gi.en less than 5!5 years ago >*here indi.idual under 1G at the time of con.iction?
-lease note that these are the criteria y *hich the 8isclosure and arring %er.ice *ill discloseinformation aout your criminal history should you e oHered the position! 4s a responsile employer,*e *ill e assessing the accuracy of information disclosed *ithin the application *ith *hat is returnedon the completed 8% chec"! 4s such, any false information or failure to disclose information held onthe 8% chec" at application stage may result in dismissal! ailure to understand the
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APPLICANTS FROM OUTSIDE THE UK
4pplicants from outside the need to pro.ide an o.erseas criminal records chec" andEor certi
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4re you related to, or ha.e a close personal relationship *ith any memer of the school#s staH,school go.ernor, the school#s local authority Councillor or Council ocer, or any memer of the%outh*ar" 8iocesan oard of ducation
;es 3o
/f yes, state the name, relationship and position held
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DECLARATION
/ certify that all information gi.en y me on each section of this form and in supporting documents iscorrect to the est of my "no*ledge and elief, that all +uestions ha.e een fully and accuratelyans*ered, and that / possess all +uali
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EUAL OPPORTUNITIES
ADDITIONAL INFORMATION
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EUAL OPPORTUNITIES MONITORING - # i*& %( 5(i%(" +(%i(*/0 : M A!#: 20I29 @0I@9 D0ID9 50I59 (0I(5
/ consider myself to e disaled *ithin the meaning of the 8isaility 8iscrimination 4ct 1995
P/#a*# i$i+a%# 0(" +/%"a/#%&i+ ("i!i*
&his information is included as part of the duty of the school to promote race e+uality and to ensuree+ual opportunities for all staH!
White
ritishnglish%cottish
'elsh7ther: please *rite in/rish4ny other 'hite ac"ground: please *rite in
Black, Black British, Black English, Black Scottish or Black Welsh
Cariean4frican4ny other lac" ac"ground: please *rite in
Asian, Asian British, Asian English, Asian Scottish or Asian
/ndian-a"istaniangladeshi4ny other 4sian ac"ground: please *rite in
Mixed
'hite A lac" Cariean'hite A lac" 4frican'hite A 4sian4ny other Mied ac"ground: please *rite in
Chinese, Chinese British, Chinese English, Chinese Scottish or Chinese Welsh or otherethnic group
Chinese4ny other ac"ground: please *rite in
Prefer not to state
Put a cross here if you prefer not to state your ethnic group
Fai%&R#/i!i(: -lease specify or decline to ans*er
8ecline to ans*er:
S#>a/ O"i#%a%i(: -lease specify or decline to ans*er
8ecline to ans*er:
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N(%#* %( a,,/i+a%*
• efore signing this form please chec" that e.ery section has een completed!
• &he form should e returned as instructed in the details of the post!
• nclose a stamped addressed en.elope if you *ish us to ac"no*ledge your application!
• ;ou are reminded that this is an application form for a post in a Church of nglandEChurch in 'ales
6oluntary 4ided school or a oundation school in *hich the Bo.erning ody is the employer! /f youare appointed the Contract you *ill e as"ed to sign *ill include the follo*ing clause >the secondparagraph is omitted in the case of a oundation school or *here you are not re+uired to gi.ereligious education?:
o 4s a teacher in a Church of nglandEChurch in 'ales school you are re+uired to ha.e regard
to the Christian character of the school and its oundation and to underta"e not to doanything in any *ay contrary to the interests of the oundation!
o ;ou may e re+uired to gi.e andEor super.ise the gi.ing of religious education in accordance
*ith the doctrines of the Church of nglandEChurch in 'ales and &rust 8eed of the %chool! ;ou are re+uired to ta"e part in and lead acts of religious *orship!
• &he successful applicant *ill e re+uired to pro.ide an nhanced 8isclosure from the 8%!
Details of referees
• 7ne referee should e your current or most recent employer! /f you are not currently *or"ing *ith
children ut ha.e done so in the past, a reference *ill e re+uired from the employer y *hom you*ere most recently employed in *or" *ith children!
• &he school *ill see" references on shortIlisted candidates, and may approach pre.ious employers
for information to .erify particular eperience of +uali