Staff Application

Fields marked with an * are required

Personal Details

Title *

Forename *

Surname *

Other names or surnames previously known by, whether formally or informally. If offered a post, original evidence of identity and name changes will be required.

Address *

Town *

County

Post code *

Home Telephone *

Mobile Number *

Other Contact Number

Email Address *

Date of Birth *

Position applied for

Gender *

Male
Female

UK Driving Licence held *

Full
Provisional

Number of points currently on License *

National Insurance No. *

DfES Number

Present Post

Date Commenced

Name of Employer/School with Contact No.

Type of School

Ages Taught

Number on Roll

Incentive Allowance/ School Group - (Head/Deputies only)

Full/Part-Time (Please state % of week) or Supply

Responsibilities

Education (In Chronological Order From Age 16)

Education

Secondary Schools

Full (F) or Part Time (P)

From

Exams Passed & Qualifications gained, including subjects, grades, class or division

College

Full (F) or Part Time (P)

From

Exams Passed & Qualifications gained, including subjects, grades, class or division

University

Full (F) or Part Time (P)

From

Exams Passed & Qualifications gained, including subjects, grades, class or division

Experience

Name of School & Local Education Authority

Type of School

Age of Children Taught

Number on Roll

Did you have responsibility for a class or tutor group? If so please describe

Additional - Name of School & Local Education Authority

Additional - Type of School

Additional - Age of Children Taught

Additional - Number on Roll

Additional - Did you have responsibility for a class or tutor group? If so please describe

Training

Course

Duration of Course

Date

Additional - Course

Additional - Duration of Course

Additional - Date

Teaching Experience

Date From

Date To

Name of School & Local Education Authority

Type of School

Year Group of Children Taught

Responsibility Points

Full/Part Time (Please state % of week) or Supply

Special Responsibilities

Additional - Date From

Additional - Date To

Additional - Name of School & Local Education Authority

Additional - Type of School

Additional - Year Group of Children Taught

Additional - Responsibility Points

Additional - Full/Part Time (Please state % of week) or Supply

Additional - Special Responsibilities

Previous Employment

Date From

Date To

Position Held (If any)

Employer or Organisation

Nature & brief summary of experience

Additional - Date From

Additional - Date To

Additional - Position Held (If any)

Additional - Employer or Organisation

Additional - Nature & brief summary of experience

Gaps in Employment

Dates From

Dates To

Reason for gap

Additional - Dates From

Additional - Dates To

Additional - Reason for gap

Personal Statement

Please indicate the ways in which your experience, skills developed and potential, fit the post for which you have applied. *

References

Name 1

Phone 1

Name 2

Phone 2

Name 3

Phone 3

Declaration

Full Name *

Date *