Bishop Wordsworth's School	

Teaching Application Form

Position applied for:		

  PERSONAL DETAILS	
Title:	Forenames:	Surname:	
Dr/Mr/Mrs/Miss/Ms/Other			
Date of birth:	Former name:	
	Preferred name:	
Teacher registration number (if applicable):	National Insurance number:	
Address:	Telephone number(s):	
	Home:	
	Work:	
	Mobile:	
	Email address:

Are you eligible for employment in the UK?	Yes	 	No	 	
If No, please provide details:	

DfES Reference Number:	 	
Do you have Qualified Teacher status?	Yes	 	No	 	
Age range for which trained:		
Have you read the school’s child protection policy?	Yes	 	No	 	
							
SANCTIONS, RESTRICTIONS & PROHIBITIONS	
Have you ever been referred to, or are you the subject of a sanction, restriction or prohibition issued by, the National College for Teaching and Leadership (NCTL), any equivalent body in the UK or a regulator of the teaching profession in any other country?                                                           	Yes	 	No	 	
Have you ever been referred to the Department for Education, or are you the subject of a direction under section 128 of the Education and Skills Act 2008 which prohibits, disqualifies or restricts you from being involved in the management of an independent school?                                                                       	Yes	 	No	 	
Have you ever been the subject of a direction under section 142 of the Education Act 2002?                                                                                                                                                                         	Yes	 	No	 	

If answering "Yes" to any of the questions in Section 2 please provide details on a separate sheet and send this in a sealed envelope marked "confidential" with your application form.
	
EDUCATION & QUALIFICATIONS	
Please list in chronological order all secondary schools, further education and higher education institutions attended, together with examinations taken and grades/degrees obtained.  Please continue on a separate sheet if necessary. 	
Name of school/college/university:	Dates of attendance:	Examinations:	
		Subject	Result	Date	
 	From:	 	 	 	
	 				
	dd / mm / yy				
	 	 	 				
	To:				
	 				
	dd / mm / yy				
	 	 	 				
 	From:	 	 	 	
	 				
	dd / mm / yy				
	 	 	 				
	To:				
	 				
	dd / mm / yy				
	 	 	 				
 	From:	 	 	 	
	 				
	dd / mm / yy				
	 	 	 				
	To:				
	 				
	dd / mm / yy				
	 	 	 				
 	From:	 	 	 	
	 				
	dd / mm / yy				
	 	 	 				
	To:				
	 				
	dd / mm / yy				

OTHER VOCATIONAL QUALIFICATIONS, SKILLS OR TRAINING	
Please provide details of any vocational qualifications or skills that you possess or training that you have received which you consider to be relevant to the role for which you have applied. 	

	

	

	

EMPLOYMENT HISTORY	
CURRENT/MOST RECENT EMPLOYMENT	
(Newly Qualified Teachers should include periods of school-based training)	
Employer's Name:	 	
Address:	

Job title:	
Subject or areas taught:	
Post responsibilities and allowances:	
Full-time    
Part-time 	LEA   
Academy   Independent       Age range:	Single Sex     Mixed    Comprehensive 	

Date started:	Date employment ended (if applicable):	Current salary / salary on leaving:	

Brief description of responsibilities:	

Reason for seeking other employment:	

Please state when you would be available to take up employment if offered:	

PREVIOUS EMPLOYMENT AND/OR ACTIVITIES SINCE LEAVING EDUCATION	
Please continue on a separate sheet if necessary	
Dates:	Name and address of employer:	Position held and/or duties:	Reason for leaving:	
From:	 	 	 	
dd / mm / yy				

To:				
dd / mm / yy				

From:	 	 	 	
dd / mm / yy				

To:				
dd / mm / yy				

From:	 	 	 	
dd / mm / yy				

To:				
dd / mm / yy				

From:	 	 	 	
dd / mm / yy				

To:				
dd / mm / yy				

Gaps in your employment: If there are any gaps in your employment history, e.g. looking after children, sabbatical year.  Please give details and dates:	
	
REFERENCES	
Please supply the names and contact details of two people who we may contact for references.  One of these must be your current or most recent employer.  If your current/most recent employment does/did not involve work with children, then your second referee should be from your employer with whom you most recently worked with children.  Neither referee should be a relative or someone known to you solely as a friend.  Bishop Wordsworth's School intends to take up references on all shortlisted candidates before interview and reserves the right to take up references from any previous employer.   
     
If BWS receives a factual reference i.e. one which contains only limited information about you, additional information may be sought. If you have previously worked overseas, BWS may take up references from your overseas employers.	
First Referee:	
Name (Including Title):	Position/Capacity know:	
Address:	Home number:	
	Mobile number:	
		
Post Code:	 Email address:	
Second Referee:	
Name (Including Title):	Position/Capacity known:	
Address:

	Home number:	
	Mobile number: 	
		
Post Code:	Email address:	
As part of the application process, all applicants are required to provide details of their online profile, including any usernames or handles associated with their social media accounts.
Please provide the following information:
•	Platform: (e.g., Twitter, Instagram, LinkedIn)
•	Username/Handle:
•	Platform:
•	Username/Handle:
•	Platform: 
•	Username/Handle:
•	Platform: 
•	Username/Handle:	
It is the School's policy to employ the best qualified personnel and to provide equal opportunity for the advancement of employees including promotion and training and not to discriminate against any person because of their race, colour, national or ethnic origin, sex, sexual orientation, marital or civil partnership status, religion or religious belief, disability or age.  
The School is committed to safeguarding and promoting the welfare of children and young people and expects all staff and volunteers to share this commitment.
A copy of the School's child protection policy is available for download from the School's website http://www.bws-school.org.uk/The_School/Policies/ Please take the time to read it.
If your application is successful, the School will retain the information provided in this form (together with any attachments) on your personnel file.  If your application is unsuccessful, all documentation relating to your application will be confidentially destroyed after six months.	

How we use your information
	
We will use the information which you have provided on this form, and which we collect from other sources (such as from references and from the Disclosure and Barring Service) for the following purposes: to assess your suitability for the role for which you have applied, to assess your suitability to work with children and to enable us to comply with our legal obligations (including safeguarding and promoting the welfare of children and young people).  
In completing this application form for employment and, if later employed, agreeing to a contract for employment,  I hereby grant permission to the School to process and share personal data provided in the form and at a later date as described on the School Staff Privacy Notice which has been given to me.

DECLARATION	
·       I confirm that the information I have given on this application form is true and correct to the best of my knowledge.	
·       I confirm that I am not named on the Children's Barred List or otherwise disqualified from working with children.	
·       I understand that providing false information is an offence which could result in my application being rejected or (if the false information comes to light after my appointment) summary dismissal and may amount to a criminal offence.	
·       I consent to the School processing the information given on this form, including any 'sensitive' information, as may be necessary during the recruitment and selection process.	
·       I consent to the school making direct contact with the people specified as my referees to verify the reference.	
·       I confirm that, to the best of my knowledge, I am not disqualified from working in early years provision or later years provision with children under the age of eight.	
	
Signed:	_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _		
 			
Date:	_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

Where this form is submitted electronically and without signature, electronic receipt of this form by the School will be deemed equivalent to submission of a signed version and will constitute confirmation of the declaration at Section 13.	

LETTER OF APPLICATION	

Name in Full:  ……………………………………………………………………………………………..
	
Please write in support of your application, showing how your experience and qualifications are relevant and how you would contribute to the post.  Considerable importance will be attached to what you say in this letter of application.  Please continue on the back and/or a separate sheet if necessary.  Please complete in black ink as this application may be photocopied.	

	
Please continue overleaf .…
LETTER OF APPLICATION Continuation…	

Name in Full:  ……………………………………………………………………………………………..

	

EQUAL OPPORTUNITIES MONITORING	

We are committed to the promotion of equality of opportunity in its employment policy, practices and procedures. To make this meaningful we need to monitor the effectiveness of our policies by analysing statistical information.

We would be grateful if you could provide us with the following information - we value your contribution which will ensure our statistics are accurate and representative of the people who are seeking employment with Bishop Wordsworth’s School.

The form will be separated from your application and treated in the strictest confidence.  The information you provide will be used for statistical purposes only and will not be used as part of the recruitment selection process

Notes on completing this form:

Ethnic origin:
The ethnic origin categories are the same as those used in the population census in 2001.  They are recommended by the commission for Racial Equality and are the basis for reporting statutory performance indicators.

Disability:
The Disability Discrimination Act 1995 states that: “a person has a disability for the purposes of the Act if they have a physical or mental impairment which has a substantial and long-term adverse effect on their ability to carry out normal day-to-day activities.”

1.	PERSONAL DETAILS

Name:  ……………………………………………………………….

(Your name is required so that we can identify which stage of the recruitment process you reach i.e. interview, appointment)

Job title:  ……………………………………………………………

School:  ……………………………………………………………..

Date of  interview:  …………………………………………………

2.	 My sex is  ( please tick as appropriate)

Male 		Female 

THANK YOU for completing the form.	3.    ETHNIC ORIGIN
I would describe my ethnic origin as: 
(Please tick as appropriate)
	
	White 
British 
Irish
Any other White background

Mixed
White and Black Caribbean
White and Black African
White and Asian
Any other mixed background

Asian or Asian British
Indian
Pakistani
Bangladeshi
Any other Asian background

Black or Black British
Caribbean
African
Any other black background

Chinese
Chinese

Other Ethnic Group (OE)
Please state: 

4.	Is there anyone who relies on you for day-to-day care and attention? (please tick) 
YES 
NO 
If YES, are they children? If Yes, which age group?

Please tick as appropriate
Children:  0-4	
5-11	
12-16	

Other family member

5.  My age is   (please tick as appropriate)

16	–19			40–49	
20	–29			50–59	
30–39			60–64	

6.  Do you consider yourself to have a disability? (Please tick)

YES 
NO 	

	Ref
WB
WI
WO

MC
MB
MA
MO

I
P
B
AO

BC
BA
BO

C