Teacher Job Ref Number:

Application
Closing date:
Please complete in black ink
Please return completed
application forms directly to the
CONFIDENTIAL SO(48) school.
The information you provide on this form will be used for recruitment
& selection and employment contract purposes

Application For Employment as:

1. PERSONAL DETAILS

Last Name and Title: First Name(s):

National Insurance Number:

Home Address: Address for Correspondence (if different):

Postcode: Postcode:

Tel No (home): Work:

Email:
Correspondence relating to this application may be sent via email to the address supplied, please confirm
that you are happy to receive such correspondence via email: Yes / No

Should you be selected for interview, please indicate dates when it would be impossible for you to attend.

For full time posts: I am applying for Job share / Part time (please delete as appropriate)
Please indicate the range of days and maximum number of hours you are able to work.

Do you hold Qualified Teacher Status: Yes / No

If Yes please provide date of award & Certificate No.
If No have you applied for Qualified Teacher Status: Yes / No

DfE Number: If not known, please state the date and name under which you are qualified

Have you completed your NQT induction period in the UK: Yes / No
If yes, please give date of completion
Are you ready with the GTC: Yes / No If yes please provide your GTC Teacher reference No.

Are you in receipt of a public service pension? YES/NO

If you are returning to teaching have you been granted Infirmity Retirement by the Department of Education and Skills
YES/NO
(If yes please give the date)

References It is expected that Teachers/Deputy Headteachers will name their present or most recent Headteacher
as their first referee. Headteachers should list their LEA or Employing Body. University leavers should name their course
tutor.
One referee should be your current or last employer.
1. Title: Name: 2. Title: Name:

Position: Position:

Address: Address:

Postcode: Postcode:
Telephone No: Telephone No:
Email: Email:

Capacity in which known: Capacity in which known:

Your referees will be automatically contacted if you are selected for interview
2. SECONDARY, FURTHER AND HIGHER EDUCATION
Date School, College, University Examinations taken or being taken or Full or Exam Result
(month and Year) or Educational Establishment any other qualifications obtained Part Time & Grade
From To (with dates)

3. CONTINUING PROFESSIONAL DEVELOPMENT/TRAINING (appropriate to the job)

Course Title Provider Dates and Duration Course completed Awards
(Yes/No) (if any)
4. EXPERIENCE

Present Post (or most Recent) Employing Authority Date of Appointment

Post Held Grade/

Allowances Salary

Previous Teaching Appointments listed in sequence. Period of Service

Please include your Teaching Practice(if this is your first appointment From To
Name of School/Unit/ Full or Title of Post Age NOR
College and LEA Part Time And Grade Range

5. OTHER WORK EXPERIENCE (please start with most recent)

Please give details in chronological order of any experience/activities which you consider relevant to teaching
e.g. commercial experience, raising a family, youth work, voluntary work.

Details and nature of work/activity Name of Employer Period of Service FT/PT

From To
6. INFORMATION IN SUPPORT OF THIS APPLICATION

(You may use this space to provide any information you wish, including any interest or unpaid activity. Ensure that you
provide a full description of all skills, knowledge and experience that you feel are relevant to the post for which you are
applying. Please restrict any additional information you wish to supply to two sides of A4 paper).

Rehabilitation of Offenders Act 1974

All posts involving direct contact with children are exempt from the Rehabilitation of Offenders Act 1974. However,
amendments to the Exceptions Order 1975 (2013 & 2020) provide that certain spent convictions and cautions are
'protected'. These are not subject to disclosure to employers and cannot be taken into account. Guidance and criteria on
the filtering of these cautions and convictions can be found on the Ministry of Justice website or see here.

Shortlisted candidates will be asked to provide details of all unspent convictions and those that would not be filtered, prior
to the date of the interview. You may be asked for further information about your criminal history during the recruitment
process. If your application is successful, this self-disclosure information will be checked against information from the
Disclosure & Barring Service before your appointment is confirmed.

Privacy Notice
The information detailed in this application form will be used in order to process your application and in line with the
school’s Recruitment and Selection process. The lawful basis for processing this information is with a view to entering
into a contract with you.
Your information may be shared may be shared with Leeds City Council HR in their role as data processor under the
terms of the service level agreement where they have a legitimate business need to access it, and externally where
required for the recruitment process, for example, in order to obtain references or where background checks are
required. Your information will only be shared where necessary, and in accordance with data protection law.
If successful, this form will be retained on your personnel file and kept for a period of 6 years after the termination of your
employment. Application forms submitted by unsuccessful candidates will be destroyed after six months from the date
the post was appointed to.

For more detailed information about how your information will be processed, and for details of their Data Protection
Officer, contact the school direct. Information regarding your rights in relation to your personal data are available via the
Information Commissioner’s Office: www.ico.org.uk.
Declaration
I confirm that the above information is complete and accurate and I understand that any offer of employment is subject
to a) references which are satisfactory to the school b) a satisfactory DBS certificate and check of the Barred list c) the
entries on this form proving to be complete and accurate and d) a satisfactory medical report, if appropriate. I confirm
that I have not been disqualified from working with children, cautioned or sanctioned in this regard.

Signature ____________________________ Date ________________