Employment Application Form – Teaching (Heathlands)

We are delighted that you have chosen to apply to work with us and we look forward to receiving your application.

We are committed to safeguarding and promoting the welfare of children and young people and expect all staff and volunteers to share this commitment.

Please ensure that you complete all sections of Part 1 and Part 2 of the application. Please note that providing false information will result in the application being rejected, withdrawal of any offer of employment, summary dismissal if you are in post, and possible referral to the police. Please note that checks may be carried out to verify the contents of your application form. CVs are not accepted.
Vacancy Job Title:*
Where did you see this post advertised?*

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Part 1: Information for Shortlisting and Interviewing
Initials:*
Surname or Family Name:*

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1. Letter of Application
Please upload a letter of application. Please refer to the applicant information pack which may include instructions on how to complete the letter of application. (Please upload a PDF / Word document)
Letter of Application*

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2. Current/Most Recent Employment: If Teaching
Job title or position:
Name, address and telephone number of school:
Type of school:
- Boys
- Girls
- Mixed
Age range
Approx. number on roll
Type of school: (E.g. Community, Voluntary Aided, Academy, Foundation, Free School, Independent, Faith etc.)
Subjects/age groups taught:
Date appointed to this post:
Date Format: DD slash MM slash YYYY
Salary:
Date available to begin new job:
Date Format: DD slash MM slash YYYY
3. Current/Most Recent Employment: If Non-Teaching
Name, address and telephone number of employer
Job title
Date appointed to this post:
Date Format: DD slash MM slash YYYY
Salary:
Date available to begin new job:
Date Format: DD slash MM slash YYYY

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4. Full Chronological History
Please provide a full history in date order, most recent first, since leaving secondary education, including periods of any post-secondary education/training, and part-time and voluntary work as well as full time employment, with start and end dates, explanations for periods not in employment or education/training, and reasons for leaving employment.
Job title or position*
Name and address of school, other employer, or description of activity*
Approx. number on roll and type of school, if applicable*
Full or part-time*
Date from*
Date Format: DD slash MM slash YYYY
Date to*
Date Format: DD slash MM slash YYYY
Reason for leaving*
Please include the continuation of your full chronological history here. Please include information from all the previous fields.
Please upload a continuation sheet if necessary. (Please upload a PDF / Word document)

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5. Secondary Education and Qualifications
Name of school/college*
Date from*
Date Format: DD slash MM slash YYYY
Date to*
Date Format: DD slash MM slash YYYY
Examination passed (i.e. A Level, GCSE), subject and grade*
Please include the continuation of your secondary education and qualifications here. Please include information from all the previous fields.
Please upload a continuation sheet if necessary. (Please upload a PDF / Word document)

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6. Higher Education
Name and address of university, college and/or university education department*
Date from*
Date Format: DD slash MM slash YYYY
Date to*
Date Format: DD slash MM slash YYYY
Full or part-time*
Courses/subjects taken and passed*
Date of examination and qualifications obtained*
Age groups for which trained*
Please include the continuation of the further or higher education here. Please include information from all the previous fields.
Please upload a continuation sheet if necessary. (Please upload a PDF / Word document)

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7. Professional Courses Attended as a Teacher
Subject (Professional courses)
Organising body
Date(s)
Date Format: DD slash MM slash YYYY
Duration
Please include the continuation of the professional courses here. Please include information from all the previous fields.

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8. Other Relevant Experience, Interests and Skills
Other Relevant Experience, Interests and Skills*

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9. Referees

Please provide details of two people to whom reference may be made. The first referee should normally be your present or most recent Headteacher or equivalent person. If you are not currently working with children please provide a referee from your most recent employment involving children. Referees will be asked about all disciplinary offences which may include those where the penalty is “time expired” if related to children. Referees will also be asked whether you have been the subject of any child protection concerns, and if so, the outcome of any enquiry. References will not be accepted from relatives or from people writing solely in the capacity of friends.

It is normal practice to take up references on shortlisted candidates prior to interview. This is in line with the most recent version of Keeping Children Safe in Education statutory guidance.
First Referee
Title and name:*
Company name:*
Address and post code:*
Telephone number:*
Email address:*
Job title:*
Relationship to applicant:*
I consent to this reference being requested before interview.*
- Yes
- No
Second Referee
Title and name:*
Company Name:*
Address and post code:*
Telephone number:*
Email address:*
Job title:*
Relationship to applicant:*
I consent to this reference being requested before interview.*
- Yes
- No

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10. Reference Declaration

In compliance with the General Data Protection Regulation (GDPR), we would like to ensure that you are aware of the data we will collect and process when requesting your references.

Reference requests sent to your referees will ask the referee to confirm as a minimum:
- The referee’s relationship with the candidate
- Details of the applicant’s current post and salary
- Performance history
- All formal time-limited capability warnings which have not passed the expiration date
- All formal time-limited disciplinary warnings where not relating to safeguarding concerns which have not passed the expiration date
- All disciplinary action where the penalty is “time expired” and relate to safeguarding concerns
- Details of any child protection concerns, and if so, the outcome of any enquiry
- Whether the referee has any reservations as to the candidate’s suitability to work with children. If so, the school will ask for specific details of the concerns and the reasons why the referee believes the candidate may be unsuitable to work with children
By checking the button below I consent to my named referees being contacted in accordance with the above*
- I consent
Date (Reference declaration)*
Date Format: DD slash MM slash YYYY

You have the right to withdraw your consent at any time and can do so by informing our organisation’s Data Protection Officer that you wish to withdraw your consent.
Please note that you will be required to sign this declaration should you be shortlisted and invited for interview.

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Part 2
This section will be separated from Part 1 on receipt. Relevant responses may be verified prior to shortlisting and/or used for administration purposes but will not then be used for selection purposes.
11. Personal Information
Surname or family name:*
Forenames*
Title*
Current address*
Postcode*
Home telephone number*
Mobile telephone number*
Email address*
Confirm email address*
DfE reference number*
Do you have a current full clean driving licence? Only applicable for posts that require driving*
- Yes
- No
- N/A
Do you require sponsorship (previously a work permit)?*
- Yes
- No

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12. Compulsory Declaration of any Convictions, Cautions or Reprimands, Warnings or Bind-overs
It is the school’s policy to require all applicants for employment to disclose any previous ‘unspent’ criminal convictions and any cautions which have not expired, or any pending prosecutions. In addition, the job you are applying for is exempt from the provisions of the Rehabilitation of Offenders Act 1974 (exceptions order 1975) which requires you to disclose all spent convictions and cautions except those which are ‘protected’ under Police Act 1997 – Part V and the amendments to the Exceptions Order 1975 (2013) and are not subject to disclosure to employers on DBS certificates and cannot be taken into account. Guidance on the filtering of “protected” cautions and convictions which do not need to be disclosed by a job applicant can be found on the Disclosure and Barring Service website.

If you are invited to interview you will be required to complete a “Disclosure of Criminal Record” form and bring the completed form to interview.

In accordance with the provisions of The Childcare Act 2006 and The Childcare (Disqualification) Regulations 2009 and Childcare (Early Years Provision Free of Charge) (Extended Entitlement) (Amendment) Regulations 2018, there is a requirement on some staff in educational settings to disclose relevant information. This requirement will apply to your application if the post you are applying for is in an Early Years setting with children (from birth until 1 September following a child’s fifth birthday) or Later Years childcare (children above reception age but who have not attained the age of 8) in nursery, primary or secondary school settings, or if you are directly concerned with the management of such childcare.

The information you give will be treated as strictly confidential. Disclosure of a conviction, caution, bind-over order, warning or reprimand will not automatically disqualify you from consideration. Any offence will only be taken into consideration if it is one which would make you unsuitable for the type of work you are applying for. However, offences relating to children may make you unsuitable since this is a “regulated position” under the Criminal Justice & Courts Services Act 2000.
13. Prohibition from Teaching
In accordance with the requirements of The School Staffing (England) (Amendment) Regulations 2013, any future appointment is subject to a check with the Department for Education to ensure that you are not subject to a prohibition order or an interim prohibition order.
14. Data Protection – Data Protection Act 2018 and General Data Protection Regulation 2018 (GDPR)
In compliance with the Data Protection Act 2018 and GDPR, we would like to inform you of the purpose for which we are processing the data we have asked you to provide on this application form. Further information is available in our Privacy Notice and Data Retention Policy which can be found on our website.

If you have any questions relating to our handling of your data you can contact us at data@heathland.harrow.sch.uk

Our Data Protection Officer, responsible for Data Protection in our organisation, is Judicium Education Limited and you can also contact them with any questions relating to our handling of your data. You can contact them at dataservices@judicium.com

The information you have provided on this form will be retained in accordance with our data retention policy.

To read about your individual rights and/or to complain about how we have collected and processed the information you have provided on this form, you can contact our Data Protection Officer. If you are unhappy with how your query has been handled you can contact the Information Commissioners Office via their website.

This form will be kept strictly confidential but may be photocopied and may be transmitted electronically for use by those entitled to see the information as part of the recruitment process.
15. Notes
(a) Under the Criminal Justice & Courts Services Act 2000 it is an offence for an individual who has been disqualified from working with children to knowingly apply for, offer to do, accept, or do any work in a ‘regulated position’. The position you are applying for is a “regulated position”.
(b) Canvassing, directly or indirectly, an employee or governor will disqualify the application.
(c) Candidates recommended for appointment will be required to provide a satisfactory Enhanced DBS certificate and complete a pre-employment medical questionnaire and may be required to undergo a medical examination.
(d) This organisation is under a duty to protect the public funds it administers, and to this end may use the information you may provide as part of the recruitment process for the prevention and detection of fraud. It may also share this information with statutory bodies responsible for auditing or administering public funds for these purposes.
16. Declaration
By checking the button below I certify that, to the best of my knowledge and belief, all particulars included in my application are correct. I understand and accept that providing false information will result in my application being rejected or withdrawal of any offer of employment, or summary dismissal if I am in post, and possible referral to the police. I understand and accept that the information I have provided may be used in accordance with section 13 above, and in particular that checks may be carried out to verify the contents of my application form.
Declaration*
- I consent
Date*
Date Format: DD slash MM slash YYYY

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Employment Application Form – Teaching (Heathlands)

Step 1 of 14

Part 1: Information for Shortlisting and Interviewing

1. Letter of Application

2. Current/Most Recent Employment: If Teaching

3. Current/Most Recent Employment: If Non-Teaching

4. Full Chronological History

5. Secondary Education and Qualifications

6. Higher Education

7. Professional Courses Attended as a Teacher

8. Other Relevant Experience, Interests and Skills

9. Referees

First Referee

Second Referee

10. Reference Declaration

Part 2

11. Personal Information

12. Compulsory Declaration of any Convictions, Cautions or Reprimands, Warnings or Bind-overs

13. Prohibition from Teaching

14. Data Protection – Data Protection Act 2018 and General Data Protection Regulation 2018 (GDPR)

15. Notes

16. Declaration

Part 3: Equality and Diversity Monitoring

Ethnicity