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job application FORM

Data Protection Notice

Throughout this form we ask for some personal data about you. We’ll only use this data in line with data protection legislation and process your data for one or more of the following reasons permitted in law: You have given us your consent or/and we must process it to comply with our legal obligations

Please ensure that you complete the form in full, otherwise your application may be rejected.

1. JOB DETAILS

  • Job you are applying for:
  • Year 1 class teacher (part-time)
  • Year 2 class teacher
  • Year 3/4 class teacher
  • Year 5/6 class teacher
Job you are applying for:
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Earliest Start Date
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  • Would you consider job sharing?
  • Yes
  • No
Would you consider job sharing?
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  • Do you wish to be added to the school mailing list?
  • Yes
  • No
Do you wish to be added to the school mailing list?
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2. YOUR DETAILS

Forenames
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Title
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Surname
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Previous Name(s):
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Home Address
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National Insurance Number
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Postcode
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Date of Birth
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  • Do you have a DBS certificate?
  • Yes
  • No
Do you have a DBS certificate?
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If Yes, please provide your DBS (Disclosure and Barring Service) certificate number:
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On what date did you receive this?
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What organisation applied for this on your behalf?
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  • Are you signed up to the online DBS update service?
  • Yes
  • No
Are you signed up to the online DBS update service?
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  • Have you the right to work in the United Kingdom?
  • Yes
  • No
Have you the right to work in the United Kingdom?
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  • Is this subject to a Work Permit?
  • Yes
  • No
Is this subject to a Work Permit?
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  • Are you related to an employee or trustee of the school?
  • Yes
  • No
Are you related to an employee or trustee of the school?
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If yes, please provide names and state the relationship.

Name
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Name
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Name
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Relationship
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Relationship
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Relationship
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3. CONTACT DETAILS

Work Phone Number
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Home Landline
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Mobile
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E-mail Addresses
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4. SECONDARY EDUCATION (beginning with the most recent)

Name and Address of School

From

To

Subject (e.g. English, Maths etc; list all)

Qualifications gained and grades (e.g. GCSE, B)

School and Address
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School and Address
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School and Address
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School and Address
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School and Address
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School and Address
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School and Address
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School and Address
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Select a date
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Subjects
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Subjects
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Subjects
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Subjects
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Subjects
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Subjects
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Subjects
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Subjects
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Qualifications
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Qualifications
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Qualifications
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Qualifications
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Qualifications
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Qualifications
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Qualifications
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Qualifications
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5. FURTHER AND HIGHER EDUCATION (beginning with the most recent)

Name and Address of College/University

From

To

Full-time or part-time

Subject studied

Qualifications achieved with dates and grades (e.g. 30/06/2005, A level Maths, B)

College/University and Address
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College/University and Address
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College/University and Address
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College/University and Address
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College/University and Address
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College/University and Address
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Select a date
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  • - select a option -
  • Full Time
  • Part Time
- select a option -
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  • - select a option -
  • Full Time
  • Part Time
- select a option -
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  • - select a option -
  • Full Time
  • Part Time
- select a option -
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  • - select a option -
  • Full Time
  • Part Time
- select a option -
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  • - select a option -
  • Full Time
  • Part Time
- select a option -
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  • - select a option -
  • Full Time
  • Part Time
- select a option -
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Subject
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Subject
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Subject
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Subject
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Subject
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Subject
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Qualifications
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Qualifications
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Qualifications
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Qualifications
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Qualifications
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Qualifications
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6. WORK EXPERIENCE

Please state all periods of employment in any position. Including new roles assigned through promotion within the same institution, as separate jobs. Please state whether any period of service was on behalf of a supply agency. Please state all periods of previous employment even if not directly relevant to the post your applying for.

A) MOST RECENT POST OF EMPLOYMENT (if applicable)

Name and address of employer
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Postcode
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Job Title
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Present salary and grade
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Reason for leaving, if not in post
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Date of appointment:
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Notice Period required if in post
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Date of leaving
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Please give a brief description of your present duties and responsibilities.
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B) PREVIOUS POSTS OF EMPLOYMENT (if applicable) (please state all, even if not relevant to the post you are applying for)

Name and address of employer
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Name and address of employer
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Name and address of employer
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Name and address of employer
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Name and address of employer
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Position held and duties involved
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Position held and duties involved
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Position held and duties involved
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Position held and duties involved
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Position held and duties involved
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From
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From
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From
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From
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From
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To
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To
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To
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To
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To
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Full/Part-time & hours per week
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Full/Part-time & hours per week
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Full/Part-time & hours per week
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Full/Part-time & hours per week
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Full/Part-time & hours per week
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Reason for leaving
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Reason for leaving
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Reason for leaving
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Reason for leaving
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Reason for leaving
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7. TRAINING

Please state all professional development courses and training undertaken during the past 5 years.

Course
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Course
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Course
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Course
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Course
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Course
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Duration
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Duration
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Duration
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Duration
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Duration
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Duration
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Date of course
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Date of course
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Date of course
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Date of course
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Date of course
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Date of course
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Full/Part-time (state hrs)
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Full/Part-time (state hrs)
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Full/Part-time (state hrs)
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Full/Part-time (state hrs)
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Full/Part-time (state hrs)
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Full/Part-time (state hrs)
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8. SELECTION CRITERIA

The information you provide in your personal statement will be used to assess your application. The selection criteria for the post are set out in the accompanying job description and person specification. Your personal statement should state in sufficient detail how the skills, knowledge, experience and personal qualities you have meet the selection criteria. You should also demonstrate that you meet the requirements of the job by giving examples of work done in the past.

SUPPORTING STATEMENT

Outline how the experience, skills and training you have gained both inside and outside paid work or through study meet the selection criteria for the post you have applied for. Please make full use of this section as short listing is conducted on the basis of the application form and statement only. (Maximum 700 words)

Supporting Statement
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REFERENCES

References will be taken up for short-listed candidates. Please give the name and addresses of four referees here. One must be your present, or most recent, employer, another must be a recent employer. These referees must be members of senior leadership/management. If you have more than one job, it will be necessary for you to provide details of all your employers even if there are more than two. The other two referees must be individuals of social standing due to their professional or community role, who know you well. For example, these can be a community leader you have met with often, an imam of a masjid you frequent, a GP that you see frequently, an accountant that you have had dealings with and so on.

Referee 1

Referee Name
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Position held and relationship to you
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Address
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Postcode
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Telephone
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Email
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Referee 2

Referee Name
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Position held and relationship to you
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Address
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Postcode
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Telephone
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Email
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Referee 3

Referee Name
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Position held and relationship to you
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Address
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Postcode
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Telephone
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Email
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Referee 4

Referee Name
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Position held and relationship to you
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Address
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Postcode
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Telephone
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Email
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8. REHABILITATION OF OFFENDERS ACT

PLEASE READ CAREFULLY Because of the nature of the work for which you are applying, this post is exempt from the provision of the Rehabilitation of Offenders (Exceptions) (Amendments) Order 1986. Applicants are, therefore, not entitled to withhold information about convictions which for other purposes are “spent” under the Provisions of the Act and, in the event of employment, any failure to disclose such convictions could result in a dismissal or disciplinary action by the school. Any information given will be kept completely confidential and will be considered only in relation to any application for positions to which the Order applies. You are asked to note that a check will be carried out on Police records for details of any criminal offence.
  • Have you ever been convicted of a criminal offence?
  • Yes
  • No
Have you ever been convicted of a criminal offence?
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If ‘yes’ to any of the questions, please email the details to [email protected]. Responses will be treated kept private confidential.

9. DISQUALIFICATION

PLEASE READ CAREFULLY 'Disqualified' individuals are not permitted to work in a setting providing care for children aged 8 and under, unless they apply for, and are granted, a waiver by Ofsted. A person is 'disqualified' if, for example, s/he has committed offences involving violence or a sexual offence against children or adults, including murder, manslaughter, kidnapping, false imprisonment, ABH and GBH; or offences such as those against children (including those that result in inclusion on the Children’s Barred List); or a Sexual Offence Prevention Order (SOPO); or possession of indecent photographs of children. A person can also be 'disqualified by association', if they are living with someone who has been convicted of a serious crime, such as those listed above, and the conviction is 'unspent'.
  • Has a Prohibition Order ever been made against you?
  • Yes
  • No
Has a Prohibition Order ever been made against you?
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  • Are you Disqualified to work with children By Association or otherwise?
  • Yes
  • No
Are you Disqualified to work with children By Association or otherwise?
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  • Are you living with someone who has been barred from working with children (through the DBS)?
  • Yes
  • No
Are you living with someone who has been barred from working with children (through the DBS)?
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  • Are you living in the same household as someone who has been disqualified from working with children under the childcare Act 2006?
  • Yes
  • No
Are you living in the same household as someone who has been disqualified from working with children under the childcare Act 2006?
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  • Please confirm whether you have ever been the subject of a child protection concern either in your work or personal life, or have been the subject of any disciplinary action, including any which are time expired.
  • Yes
  • No
Please confirm whether you have ever been the subject of a child protection concern either in your work or personal life, or have been the subject of any disciplinary action, including any which are time expired.
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  • Are you on the Barred list database or have you ever been Disqualified from working with children or been subject to any sanctions imposed by a regulatory body (e.g. the DfE)?
  • Yes
  • No
Are you on the Barred list database or have you ever been Disqualified from working with children or been subject to any sanctions imposed by a regulatory body (e.g. the DfE)?
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If ‘yes’ to any of the questions, please email the details to [email protected]. Responses will be kept private and confidential.

10. DECLARATION

I hereby certify that, to the best of my knowledge and belief, the information given in this application is true and accurate. I understand that if the information is false and misleading it will disqualify me from appointment or could lead to dismissal or disciplinary action after appointment.

Should any of the particulars furnished in answer to any questions in this form be found to be false within the knowledge of the candidate or should there be any wilful omission or suppression of any material fact, the candidate will, if appointed, be liable to be dismissed.
Your Full Name
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Select a date
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GENERAL DATA PROTECTION REGULATIONS

In order to process your application you are requested to complete and return this application form. Unique Academy (UA) will treat the information you have provided in accordance with the provisions of the General Data Protection Regulations, including ensuring it is kept confidentially, is not passed onto to a third party without your consent and, for unsuccessful candidates, is erased within 12 months.

EQUAL OPPORTUNITES STATEMENT

Unique Academy (UA) complies with the provisions of the Equality Act 2010

EQUAL OPPORTUNITES STATEMENT

Unique Academy (UA) complies with the provisions of the Equality Act 2010

11. ADDITIONAL INFORMATION FOR MONITORING PURPOSES

DISABILITY

The Disability Discrimination Act 1995 (DDA) protects people with disabilities. The DDA defines a person as disabled if they have a physical or mental impairment, which has a substantial and long term (i.e. has lasted or is expected to last at least 12 months) and has an adverse effect on the person’s ability to carry out normal day-to-day activities.
  • Do you consider yourself to have a disability according to the terms given in the DDA?
  • Yes
  • No
Do you consider yourself to have a disability according to the terms given in the DDA?
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If you have answered yes to having a disability, please let us know how we can support you at the interview.
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Please tick if any of the following types of disability apply to you. People may experience more than one type of disability, in which case tick all the types that apply. If your disability does not fit any of the types, please mark ‘Other’ and state your disability.

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If you ticked ‘yes’ to the question above, please state the disability:
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ETHNICITY

Please select one category below and then tick the appropriate box within that section to indicate your ethnic background. If you are ticking one of the ‘Any other’ boxes please state your ethnicity in the space provided.
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Other white background
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Other mixed background
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Other mixed background
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Other background
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Other background
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MEDIA

Where did you hear about the vacancy?
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Other website(s) please state
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Please state the name
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