Please read the guidance before completing this form.

It explains how to complete the form and contains some

advice which may help you to submit a better application.
Pre-employment screening checks may be undertaken on recruitment applications and applicants
for the purposes of confirming information requested and provided within this application form.
2. Personal Details
If you have lost/cannot recall your teacher Reference Number please contact the GTCE
by calling +44 (!"# $ "%
Which subject area(s) did you specialise for in teacher
training
!heology"history of religion
#ther subject areas of interest e.g. sport" music" drama
!heatre"music"dance"handcrafting
$o you have the %ational Professional &ualification for 'eadship (%P&')
(es %o
$ate awarded &ualified !eacher )tatus (&!))
*+,*-,.*/+
0re you currently registered with the 1!2 in 3ngland (es %o
4f you gained &!) after 5 6ay /777" have you completed the )tatutory
!eacher 4nduction Period
(es %o
'ave you worked as a )upply !eacher for /8 months or more
(es %o
4f you have indicated that your induction period is part completed" please
provide the name of the appropriate body where your induction period
was undertaken.
!eacher 9eference %o:
(formerly $f3) %umber)
x
x
x
x
;amily name:!ica
0ddress: %icolae <alcescu n .- "6i=il" Prahova"
9omania
#ther names:$orin %icolae
Previous names:
!itle:6r
2ontact telephone no: >?* *5-?587-@/ Postcode:/*@-**
3mail:dorinticaAyahoo.com %ational 4nsurance %o:
1. Post Details
Post applied for: class teacher
Post 9ef:)chool ref no 3teach
@..--?
$epartment:3ducation Bocation:Beicester
Belgrave St Peters CE (A) Primary School
Application Form for a Teaching
Post
5. Summary of Experience, Skills, Knowledge and ompetencies!
Please tell us about your relevant eCperience" skills" knowledge and competencies which you think make you the best
person for the job" always referring to the person specification. 2ontinue overleaf or use additional paper if necessary.
"a. Experience #$%is s%ould include paid and unpaid employment, work
experience, placements etc.& Please list most recent post first. Please continue on
a separate s%eet if necessary.
l
)alciile )chool
"'. Please specify all time not accounted for a'o(e wit% dates and reasons!

#rganisation 9ole
)alary (if
applicable)
Period ;rom
66,((((
!o
66,((((
9eason for
leaving
)chool %o /
!ase $umitrescu 'igh
schoool
Theology teacher
History of
religions teacher
200 o!n"s
200 o!n"s
200 o!n"s
#$%$20#2
#$%$20#2
#$&$20#'
#$%$20#'
(e) choices
(e) choices
Bol"esti *ra"istea School
S!ly teacher
theology
#$%$200%

#$&$20#2
). Present Employment #if you are currently not in employment, please lea(e 'lank&
Dob title:!heology teacher !elephone %o: >?* *5-?587-@/
3mployerEs name: )chool %o./
6ay we contact you on this number yes %o
0ddress:6ihai <ravu )treet n /*-"6i=il"9omania
<asic pay,grade:
0llowances:
$ate started:/,-,.*/.
Postcode:/*@-**
Period of notice:
6y areas of eCpertise in education are quite versatile"for eCample problem solving and class
management are few of them"4 lead many childrens among years of teaching in a position of
class master"here 4 confronted many problems and situations that can lead to school dropout.
+ am a teacher )ith more than six years of exerience in e"!cation , an" + am a erfect match for the osition yo!
a"vertise" in ree"-com-!.-
+ am a rofessional, committe", /!alifie" teacher )ho hoes to 0!il" on the exerience + have gaine" thro!gh my
st!"ies in 1omania (2niversity of B!charest) an" )or. lacements 0y gaining emloyment as a rimary,
secon"ary school an" highscool teacher-
+ am /!alifie" to teach Theology ,3!sic an" History of religion in any age4range chil"ren accor"ing to
5TS(teacher reference n!m0er #6&'&%&)-
S!ly m!sic an"
+nformatics teacher
#70 o!n"s #$%$200% #$&$20## 8!ll teacher
#utline of key duties and responsibilities: !eaching !heology and 'istory of religions from F) /"F)." ks+"!o
promote equality as an integral part of the role and to treat everyone with fairness and dignity"#rganising and
supervising school eCcursions" outdoor education "!o apply and promote human valors to every aspect of life"
parenting" personal piety"
x
*. riminal on(ictions and autions
!he 9ehabilitation of #ffenders 0ct /75? (3Cceptions) #rder /75@ does not allow employees with access to
children and young persons under the age of /- years the right to withhold information regarding previous
criminal convictions" as well as cautions" reprimands and warnings" for any offence (not just those involving
children) which for any other purposes
are GspentE under the provisions of the 0ct. (ou should disclose in this section all previous convictions"
cautions" reprimands and warnings.
;ailure to disclose any previous convictions" cautions" reprimands and warnings" could result in dismissal should it
be subsequently discovered.
+ny information gi(en eit%er w%en returning t%is application form or at inter(iew will 'e entirely
confidential and will 'e considered only in relation to t%is application.
4 confirm 4 have no convictions" cautions" reprimands or warnings" or are on the relevant 4)0 <arred Bist(s)"
disqualified from working with children" or subject to sanctions imposed by the 1eneral !eaching 2ouncil
(1!2).
4f you do have any criminal convictions" cautions" reprimands or warnings" or are subject to sanctions
imposed by the 1eneral !eaching 2ouncil (1!2)" please give details in a sealed envelope and attach this to
your application form.
x
,. -elations%ips
0re you related to any 3lected 6ember or employee of the Beicester 0cademies 2haritable !rust or a 1overnor of a
school,college
(es %o 4f yes" please give details:
x
5. Summary of Experience, Skills, Knowledge and ompetencies (continued)
4 am able to effectively communicate with students from diverse backgrounds or varying
degrees of ability" analy=ing problems" advising childrens " imagining new solutions.0
dedicated professional with a proven ability to teach" motivate and direct students to
maCimum performance by encouraging a positive and energetic environment.
4 describe myself as a good person with initiative wich looking for a chance to prove this in new
environment than my country.
6y core strengths include"but are not limited to the following:
2reating a comfortable and stimulating classroom atmosphere
!o apply and promote human valors to every aspect of life" parenting" personal piety"
ethics" church" civil and others
Planning and preparing lessons in order to deliver the %ational 2urriculum
6aintaining good order and discipline among the pupils
4 would welcome the opportunity to further discuss my skills and this position. 4f you have
questions or would like to schedule an interview" please contact me by phone at >?*
*5-?587-@/ or by e-mail at dorinticaAyahoo.com 4 have enclosed my resume for your review.
4 look forward to hearing from you.
1.. -ele(ant ourses/+wards #eg s%ort courses attended/certificates/awards&
$uration
#rganising <ody <rief $etails of 2ourse,0ward ;rom !o
0. 1em'ers%ip of -ele(ant 2rganisations
Professional <ody,0ssociation
&ualification,
6embership Bevel
$ates of &ualification,
6embership (66,(((()
3. Education
&ualification gained or pending. Please state
subject. (Please be prepared to provide evidence at
interview.)
1rade e
$ate 0chieved
(66,(((()
)chool,2ollege,Hniversity
1). 4nter(iew +rrangements
Please indicate below any dates when you would not be available to attend for interview:
12. Data Protection +ct
!he information you supply when requesting a job pack will be held in electronic format for monitoring and
evaluation purposes and in connection with any future contact. !his information will be kept for a maCimum of /-
months from last contact.
When you sign and return this form you are giving permission to process and hold the information you have
supplied on it" including any information you consider to be personal and sensitive. 4f your application is
unsuccessful" the form will be held for up to 8 months and then destroyed. !he information may be used by !he
Beicester 0cademies 2haritable !rust for the purposes of equality monitoring" compiling statistics and maintaining
other employment records.
11. Disa'ility/5ealt% onditions
We encourage people with disabilities to apply for jobs and uses the G!wo !icksE $isability )ymbol. !his means
that the Beicester 0cademies 2haritable !rust is committed to interviewing all applicants with a disability who
meet the essential criteria for a job vacancy and to consider them on their abilities.
$%e E6uality +ct 2.1. defines disa'ility as!
A physical or mental impairment which has a substantial and long term adverse effect on the ability to
carry out normal day-to-day activities.
Please see notes of guidance for further clarification of this definition.
4 consider myself! Disa'led 7on8Disa'led
Please indicate below if you require any reasonable adjustments" due to a disability or health condition" to enable
you to attend an interview" or which you wish us to take into account when considering your application:
4nterview information in audio format Wheelchair-accessible location for
4nterview information in large print format
interview and tests if applicable
)ign
language interpretation or other
2ar parking space for interview
assistance
with communication at ;acility for personal carer" assistant
interview or other person to accompany you at
4nduction loop in interview room
interview
Please specify any other support which you would like to be made available on the day:
15. Declaration
4 declare t%at t%e information 4 %a(e gi(en on t%is form is, to t%e 'est of my knowledge, correct, true and
accurate and t%at 4 %a(e not omitted any facts w%ic% may %a(e any 'earing on my application. 4
understand t%at falsification of a 6ualification or any ot%er information may lead to t%e wit%drawal of any
offer of employment, or dismissal w%ere employment %as already commenced.
9y signing t%is form 4 agree to $%e :eicester +cademies %arita'le $rust using t%is information to
consult any t%ird parties or external organisations for t%e purposes of confirming and/or clarifying suc%
information.
4 also confirm t%at 4 %a(e not directly or indirectly approac%ed any ;o(ernor of t%e
academy/sc%ool/college w%ere t%is post is 'ased to support me in making t%is application, as t%is would
dis6ualify me as a candidate.
4 understand t%at if 4 don<t tell you a'out any relations%ips wit% any mem'er or ;o(ernor of a
academy/sc%ool/college, or 4 neglect to tell you a'out any criminal con(ictions, cautions, reprimands or
warnings as detailed in t%e guidance notes, and t%is is disco(ered after appointment, 4 could 'e dismissed
wit%out notice.
4 also understand t%at satisfactory references, -9 disclosure, medical clearance and e(idence of t%e rig%t
to work in t%e =K are re6uired 'efore any final offer of employment can 'e made.
)ignature: $ate:
If you are applying online you &ill be re'uire( to bring a signe( application form &ith you to the intervie&)
1". -eferences
#ne of your references should be your present or most recent employer.
0s this post has been designated as a Gregulated activityE" it will be necessary for both referees to be approached
before the interview.
/. %ame: .. %ame:
0ddress: 0ddress:
Postcode: Postcode:
3mail address: 3mail address:
!elephone %o: !elephone %o:
!itle,Position: !itle,Position:
9elationship to applicant: 9elationship to applicant:

1,. 1onitoring Section

4t would be really helpful if you could complete this section for us. !he 1overning <ody and the Beicester
0cademies 2haritable !rust is committed to equality of opportunity in employment and service delivery and the
information you provide will help us to ensure fair and equal treatment of applicants and employees alike.
!he details you supply will be stored separately from the information on the rest of the application form and will
not be used as a basis for decision-making within the selection process.
$epartment:
Post 9ef: Bocation:
0pplication for post of:
1& 5ow would you descri'e your et%nicity>
Prefer not to state
2& 1y sex is ?emale 1ale Prefer not to state
)& 1y date of 'irt% is #DD/11/@@@@&! +ge!
"& $%e E6uality +ct 2.1. defines disa'ility as!
*+ physical or mental impairment &hich has a substantial an( long term a(verse effect on the ability
to carry out normal (ay,to,(ay activities)-
4 consider myself Disa'led 7on8disa'led Prefer not to state
5& 1y -eligion or 9elief is!
9udd%ist %ristian #all denominations& 5indu Aewis% 1uslim
Sik% 7one Prefer not to state 2t%er Please specify:
,& 1y Sexual 2rientation is!
9i8sexual ;ay :es'ian 5eterosexual Prefer not to state
2t%er Please specify:
*& B%ere did you see t%is (acancy ad(ertised> (Please be specific e.g. Beicester 6ercury)
#a& B%ite or B%ite 9ritis%
<ritish
4rish
0ny other White background
(please write in below)
#'& 1ixed
White and <lack 2aribbean
White and <lack 0frican
White and 0sian
0ny other miCed background
(please write in below)
#c& +sian or +sian 9ritis%
4ndian Pakistani
<angladeshi
0ny other 0sian background
(please write in below)
#d& 9lack or 9lack 9ritis%
2aribbean
0frican
0ny other <lack background
(please write in below)
#e& %inese or ot%er
et%nic group
2hinese
0ny other ethnic group
(please write in below)
#f& ;ypsy/$ra(eller
4rish !raveller
9omany 1ypsy
0ny other background
(please write in below)
0ppointed )hortlisted 4nterviewed #;;423 H)3 #%B(