Application Form: Teaching Staff

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Page: 1 Application Form: Teaching Staff Before you begin Read the advertisement and any additional supporting information provided, including: The job description, which lists the tasks you will be expected to carry out and describes how the job fits in with other employees. The person specification, which details the experience, skills and abilities needed for the role. It is vital that your application demonstrates how you meet these requirements. In order to improve your chances of being selected, use specific examples from your experience and relate them to the person specification, job description and any other information provided. It is in your interest to complete the form in such a way as to maximise your chances of being selected. Supporting statement Please complete this and remember to relate your skills, knowledge and experience to the job description and person specification when completing this section. It is important to clearly address each point in the Person Specification. Important notes If you want to complete the form electronically and email it to us: 1. You can type into the form, and can return the completed version to us via email: recruitment@clapton.hackney.sch.uk 2. You will not be able to sign the form on page 10. By emailing the form to us, you declare that the information on this form, and your answers to the section on the Rehabilitation of Offenders Act 1974, are true and accurate. Email is taken as substitute for your signature. If you want to print the form and send it via post: 1. If you are completing the form by hand, please complete in black ink and ensure that it is legible. 2. Do not write outside the lines. 3. Ensure you mark each sheet with your full name. 4. Provide full date details for current and previous employment for continuous service purposes using the format (mm/yy). 5. Ensure that you have read and understood the declaration on page 10, and that you have signed and dated your completed application form before returning it. You may find it useful to keep a copy of your completed application form for your own personal records. Please return completed application forms to: HR department, Clapton Girls Academy, Laura Place London E5 0RB

ALL INFORMATION WILL BE TREATED IN THE STRICTEST CONFIDENCE Page: 2 Please ensure you read the guidance notes on the cover page before filling in this form. If you are completing it online, do not complete it in uppercase. Your Application (All fields with * MUST be completed) *Application for the post of: *How did you hear of this post? *Have you applied to us before? Yes No *If so, which position, and when? Personal Details (All fields with * MUST be completed) *Surname: *Forename(s): *Previous name/maiden name (if applicable): *Title: *DFE No.: *Address: *Post Code: *Home phone: *Work phone: *Email: *Mobile: *Preferred means of contact: *National Insurance No.: May we contact you at work? Yes No Asylum and Immigration Act (All fields in this section must be completed) Before you commence working, you MUST provide evidence to demonstrate your right to work in the United Kingdom. If you are appointed to a post you will receive further guidance. Are you eligible to work in the UK? Yes No Is this subject to a Work Permit or Visa? Yes No If yes, please select the category that relates to your current immigration status. This status will be checked on the interview date. HSMP/Tier 1 Indefinite leave to remain/enter Work permit/ Tier 2 Dependent/ Spouse Visa Ancestry Visa Clinical attachment Visa Student Visitor Tier 5 Temporary Workers Working Holiday Visa Post Graduate Doctors & Dentists Refugee Other, please specify: Please supply details of any visa currently held, including number, start/ expiry dates and details of any restrictions: Visa No.: Start Date: Expiry Date: Does your visa have a condition restricting employment or occupation in the UK? Yes No

Page: 3 Your application (Please fill in all applicable sections) Please give the date that you successfully completed the National Skills Tests. Please put N/A in the boxes that are not applicable to your Qualified Teaching Status. If you have not yet passed the required tests, please give the date of your next test. Numeracy: Literacy: ICT: Have you started your induction period? Yes No If yes, date commenced: School/LA: Are you recognised by the DFE as a qualified teacher in this country? Yes No DFE number: Date when qualified: QTS number: Age range qualified to teach: Subjects qualified to teach: NPQH date completed: NPQML date completed: NPQSL date completed: or date when enrolled: or date when enrolled: or date when enrolled: Have you successfully completed a period of probation/induction as a qualified teacher in this country as required by the DFE? Yes No If appointed, when would you be able to commence employment? Teaching and work experience (Please fill in all applicable sections) Current or last position of employment Present post (title): Date appointed: Name of school: Address: Telephone: Postcode: Age range: Boys/Girls/Mixed: Name of Education Authority: Point on scale: Salary: Additional allowances (if applicable): If you are on the Upper Pay Scale, at what date were you placed on your current scale? Reason for leaving: Brief description of duties/responsibilities:

Previous teaching posts held (Please enter earliest first, continue on separate sheet if necessary) Page: 4 Name of local authority and status eg Foundation, Community or Academy Trust etc. Name of school or college (including location) Boys Girls or mixed Age range Post title and scale

Non-teaching employment Page: 5 This should include any employment after the age of 18, i.e. clerical, social, industrial (excluding casual employment). Please continue on separate sheet if necessary Employer Position held Duties If you have any gaps in your employment history, please explain below:

Education and Teaching qualifications and courses attended Page: 6 Please fill in all applicable sections. Please note: Qualifications/Grade MUST be completed. Applications without this information may not be considered. Secondary school, college, higher education Name of institution Qualification / Grade Subject Further education Name of institution Qualification / Grade Subject Post graduate study Name of institution Qualification / Grade Subject Courses/training Name of institution Qualification / Grade Subject

Reason for applying Page: 7 Please describe clearly how you meet the requirements of the person specification addressing each point in turn. Give examples where appropriate. Also include further information about yourself that you feel is relevant. Please ensure you read the Recruitment and Selection Guidance Notes before completing this section. This section is limited to 2 sides of A4.

Reason for applying continued Page: 8

Page: 9 References (All fields in this section MUST be completed) Please give the names and addresses of two individuals, not related to you, from whom we may obtain references. Both of them MUST be professional references. If you are working then one of these must be your current employer. If you work in education then one of these must be your current Headteacher. However, if you are a student or have been out of work for a period of time then teachers or a previous employer will be sufficient. Please remember that the referees you give should be able to comment on your ability to perform the job for which you are applying. If you do not provide us with two full references, the progression of your application form might be affected. NQTs should include their initial teacher and a successful teacher practice school. Reference 1 Name: Title (Mr, Ms, Miss, Mrs, Mx etc.): Organisation name: Job title: Relationship: Address: Postcode: Telephone: Email: May we contact this referee prior to interview if shortlisted? Yes No Reference 2 Name: Title (Mr, Ms, Miss, Mrs, Mx etc.): Organisation name: Job title: Relationship: Address: Postcode: Telephone: Email: Your second referee will be contacted prior to interview if you are shortlisted.

Rehabilitation of Offenders Act 1974 (All fields in this section MUST be completed) Page: 10 All posts involving direct contact with vulnerable children are exempt from the Rehabilitation of Offenders Act 1974. The amendments to the Exceptions Order 1975 (2013) provide that certain spent convictions and cautions are protected. These are not subject to disclosure to employers and cannot be taken into account. Guidance and criteria on the filtering of these cautions and convictions can be found on the Disclosure and Barring Service website and the Recruitment and Selection Guidance Notes. Please answer the following questions: Have you been convicted of a criminal offence which is not protected? Yes No If yes, provide details in a sealed envelope marked confidential and attach to this form. Signed: (see Note below) Date: Have you previously used or do you currently use any other forename(s), surname(s) or aliases (including maiden names)? Yes No If yes, please state name(s) and dates used: Reasonable Adjustments to Shortlisting Process We welcome applications from candidates with disabilities. Please indicate in the box below if there is anything that we need to do, or take into consideration, to ensure that the shortlisting process is fair in relation to a disability. Declaration ( be signed by all applicants) Are you related to any member of this school s Governing Body or other member of staff? Yes No If yes, please give details: I have read and understood the information contained in this application form. I declare that all information provided in this application form is true and accurate to the best of my knowledge. I understand that omissions or incorrect statements will disqualify me, or if appointed, I will be liable to be dismissed. I confirm that I have not been disqualified from working with children, cautioned or sanctioned in this regard. This declaration constitutes part of the terms of contract if I am appointed. Signed: (see Note below) Print name: Date: Note: If you email this form to us (i.e. you can t sign it) then it is assumed that you declare that the information on this form, and your answers to the section on the Rehabilitation of Offenders Act 1974, are true and accurate.

Previous teaching posts held (continuation sheet) Page: 11 Name of local authority and status eg Foundation, Community or Academy Trust etc. Name of school or college (including location) Boys Girls or mixed Age range Post title and scale

Non-teaching employment (continuation sheet) Page: 12 Employer Position held Duties

Monitoring Teaching Equal Application Opportunities Form Monitoring Equal Opportunities Page: 13 Clapton Girls Academy aim to select all staff on merit, irrespective of race, sex, disability, age or other protected characteristics. In order to monitor the effectiveness of our equality policy and recruitment procedures, we ask that all applicants complete this form and return it with their application. In accordance with the Data Protection Act 1998, the information provided will only be used for the purposes of equality monitoring and to inform improvements to our policies. The form will be separated from your application upon receipt and will not be shared with the selection panel. Personal and post details Name: Date of birth: Post applied for: Sex: Male Female National Insurance No.: Marital status Single Married Civil partnership Living with partner Widow/widower Divorced Separated Do not wish to disclose Religion or belief Catholic Buddhist Sikh Hindu Jewish Jain Muslim Church of England Orthodox Jewish/Charedi Other, please specify: Do not wish to disclose Caring responsibilities Do you have a carer responsibility for anyone? Yes No Do not wish to disclose If yes, are they? Adults Children Do not wish to disclose Sexual orientation Heterosexual Lesbian Gay Bisexual Do not wish to disclose Transgendered Are you transgendered or transexual? Yes No Do not wish to disclose

Monitoring Teaching Equal Application Opportunities Form Ethnic group Page: 14 Asian or Asian British: Bangladeshi Chinese Indian Pakistani Any other Asian background, please specify: Black or Black British: African [1], please specify: Any other Black background, please specify: Caribbean Mixed: White & Black Caribbean White & Black African White & Asian Any other Mixed background, please specify: White: British Other [2], please specify: Irish Other: Any other background [3], please specify Do not wish to disclose Notes [1] Angolan, Congolese, Ghanaian, Nigerian, Sierra Leonean, Somali, Sudanese, any other Black African. [2] Turkish, Turkish Cypriot, Traveller of Irish Heritage, Albanian, Greek/Greek Cypriot, Gypsy/Roma, White Western European, White Eastern European, any other White. [3] Afghan, Kurdish, Latin/South/Central American, any other ethnic group.