Application Form

Post Title* Closing Date*

Personal Details

*
	Surname	Other Names

Preferred Title (e.g. Mr, Mrs, Miss, Ms)* Home Address*

	Home Telephone	Mobile Telephone

Email Address

If you have provided an email address, this will be the method by which you will be contacted.

National Insurance Number*

Do you hold a Qualified Teacher Status?*YesNo

If yes, please give date of award & Teacher Reference number (TRN):

If no, are you registered with The Teaching Agency as an Instructor? Please provide your TRN in the box above*YesNo

Are you entitled to work in the UK (You will be asked to provide evidence)*YesNo

Do you need a Certificate of Sponsorship?*YesNo

Do you hold a full valid driving license?*YesNo

Do you have the daily use of a car?*YesNo

Have you previously sought employment with Wexham Court Primary School?*YesNo

If yes, please give details

Present Employment

If currently unemployed please give details of last employer

Name, address and telephone number*

*
	Date of commencement	Job Title	Date appointment ended

Please give a brief description of your duties*

*
	Present basic salary	Notice required

*
	Full or part time	Reason for leaving

Employment History

Please list your work experience since leaving full time education. Start with the most recent employer. All employment gaps must be accounted for.

	Dates (from-to)	Employer's name & address	Job title and brief summary of duties and reason for leaving

Periods when not employed
	Start date	Finish date	Reason

Voluntary/Unpaid Activities*
	From	To	Position	Details of duties	Organisation name

Secondary Education

You will be required to produce evidence to demonstrate you have obtained all qualifications that you rely upon to support your application

	Dates (from-to)	Name & address of School	Qualification	Grade

Further Education
	Dates (from-to)	Name & address of School	Qualification	Grade

Are you a member of a professional body?*YesNo

If yes, please specify

Supplementary Questions

This post is exempt from the Rehabilitation of Offenders Act 1974, therefore all convictions, including all spent convictions, must be declared.

Do you have any past, present or pending convictions, cautions, warnings, prosecutions or bind overs?*YesNo

(For Teaching Posts only) Have you ever had any sanctions and/or warnings imposed by the Teaching Agency?YesNo

If so, please give details

Have you ever had any sanctions and/or warnings imposed by the Department for Education?YesNo

If so, please give details Teaching posts - Please give details of special areas of teaching interest

Do you have a personal relationship with any employees of the school or a member of the Governing Body of the School or Slough Borough Council?*YesNo

If yes, please give details What are your interests?* Where did you see this job advertised?*

Do you have a disability?*YesNo

If so, please state what type of adjustments to arrangements that would assist you in overcoming any disadvantage your disability might otherwise cause you during the recruitment and selection process and / or at work.

References

Please give the names and addresses of two referees, one of which MUST be your present or last employer or Head Teacher/tutor if a school or college leaver. If your work does not currently involve working with children however you have worked with children in the past, please provide details of a suitable referee from the organisation where you most recently worked with children. Please note that as part of our commitment to safeguarding the welfare of children and young people it is our policy to obtain all references prior to interview.

*
	Name of referee	Job title

*
	Name & address of organisation	Email address

*
	Telephone number	Relationship to you

May we approach this referee before interview?*YesNo

*
	Name of reference	Job title

*
	Name & address of organisation	Email address

*
	Telephone number	Relationship to you

May we approach this referee before interview?*YesNo

I declare that the information set out in this application form is true, accurate and complete. I understand that if my application is incomplete this form may be returned to me for completion before it can be considered. I also understand that if I have omitted facts which may have a bearing on my application or if there are any anomalies on this form these will be explored by the school. Any false statement will result in rejection as a candidate and/or dismissal if appointed, and if appropriate, possible referral to the police.

In accordance with the Data Protection Act I expressly agree that the school may use and process the information on this form as necessary, and for any legitimate purposes of the School.

For the following statements please tick the appropriate box

I have not been placed on either the Children’s List or the Adult’s List. I have not been disqualified from working with children, or subject to sanctions imposed by a regulatory body, e.g. the DfE and / or The Teaching Agency (formerly known as the GTCE). I have no convictions, cautions, warnings, prosecutions or bind overs, past, present or pending.

*I have not

I have attached details of my record referred to above in a sealed envelope marked confidential. These details will not be considered unless you are shortlisted for the role. They will only be taken into account if we consider they are relevant to the role you have applied for, in which case we will ask you relevant questions at interview.

*I have

I understand that if I am successful, my employment will be subject to satisfactory Enhanced Criminal Records Bureau clearance and I agree to any pre-employment screening relevant to my application.

*I understand

Sign* Date*

Personal Statement

Please give your reasons for applying for this position. Outline the knowledge, skills, experience and personal qualities that are relevant to your suitability for the advertised post, and in particular please explain providing clear examples of how you meet the person specification as you will be shortlisted against these criteria. (No more than 2 sides of A4 font size 10)

Please upload personal statement here* No file chosen