Vacancy Application Form

Thank you for your interest in Osborne Co-operative Academy Trust.

The following information is necessary to ensure that full consideration

can be given to all candidates. All the information given will be treated
as confidential.

The declaration in Section 9 on page 13, of this form must be

completed before submission. If you submit this form digitally, you
will be required to provide a physically signed copy of your completed
application before any employment decision can be confirmed.

This is a digital PDF form that can been completed and submitted from any device.

If you are using a mobile phone you may find that by rotating your phone to a
landscape view it is easy to fill out the form.

If you do choose to fill out the form digitally, we recommend that you periodically
save your form as you progress through the sections.

If you prefer to complete the form on a

printed page you can use the ‘Print’
button at the foot of this page.

Please use black ink and ensure

you complete all the sections.

Submitting your form

To assist you, we have
included instructions
about ‘How to submit your
form’ on page 19.

Print Complete the form digitally

Page 1 / 19
 1 Vacancy details
Job appointment title TEACHER OF MATHS

School name BRENTWOOD COUNTY HIGH SCHOOL

If the appointment is part of the central Trust
team enter Trust.

Closing date 30 APRIL 2024

Day Month Year

How did you hear Social media

about this vacancy?
The Trust website

The School’s website

A newspaper advertisement

By word of mouth

Other…

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Page 2 / 19 Section 1 – Vacancy details
 2 Personal details
Your title Mr. Mrs.

Ms. Miss

Dr. Prefer
not to say

Other…

Your surname HOME

(Last name)

Your first name(s) JACKSON

Previous name(s) N/A

Home address 153 LONGFIELD

HARLOW
ESSEX
CM186LD

Home landline number

Mobile phone number 07362207052

Personal email address [email protected]

National Insurance No. SC904628A

Do you require
permission to Yes No
work in the UK?

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Page 3 / 19 Section 2 – Personal details
 3 Employment history
Are you currently
employed? Yes No

If Yes please complete the details below…

Current employer’s TLTP TEACHING AGENCY

name and address TO BRENTWOOD COUNTY HIGH
SCHOOL
BRENTWOOD

Employer’s phone No.

Nature of business TEACHING AGENCY

Your job title TEACHER OF MATHEMATICS

Please provide a brief TEACHIGN MATHS IN KS3, 4 AND 5

outline of your duties
in this role

Date you were 15 01 2024

appointed
Day Month Year
Salary Spine / Grade UPS

Current Salary (Point) 5

Do you receive
Yes No
any allowances?
If ‘Yes’ what type(s)?

If ‘Yes’ what value (£)?

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Page 4 / 19 Section 3 – Employment history
How much notice are you required
to give your current employer?
What are your reasons for wishing
to leave your current position?

Please check the box if you do not wish to be contacted at work.

Previous Employment
Please include all full-time and part-time positions. Please list the most recent first and continue on
a separate sheet if necessary.

A) Employer name Job title Start date End date

EDUC8 EDUCATION SERIVICES LONDON
MATHS TEACHER/SUPPLY TEACHER
13/05/23 20/07/23
Reason for leaving Salary/Grade
MOVED SCHOOL UPS3

B) Employer name Job title Start date End date

SYDNEY RUSSEL SCHOOL HEAD OF MATHS 01/05/2017 31/12/2021
Reason for leaving Salary/Grade
LEFT TO WORK FOR AN AGENCY UPS 3 + HOD ALLOWANCE

C) Employer name Job title Start date End date

WARREN SCHOOL HEAD OF MATHS 01/01/2015 31/08/2017
Reason for leaving Salary/Grade
PROMOTION TO A DIFFERENT SCHOOL UPS 3 + hod ALLOWANCE

D) Employer name Job title Start date End date

RODING VALLEY HIGH SCHOOL2i/c MATHS DEPARTMENT 07/09/2010 30/08/2015
Reason for leaving Salary/Grade
PROMOTION TO A DIFFERENT SCHOOL UPS + 2i/c ALLOWANCE

E) Employer name Job title Start date End date

RODING VALLEY HIGH SCHOOLMATHS TEACHER 01/012004 MPS
Reason for leaving Salary/Grade
N/A MPS

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Page 5 / 19 Section 3 – Employment history
If you were successful in obtaining N/A
this role, what current employment
would continue with?

If you have had any breaks in N/A

employment since leaving school,
give details of these periods and
your activities during these times
e.g. unemployment, raising family,
voluntary work, training.

4 Mobility
Please complete this section if the Person Specification for this post
includes these requirements.

Do you have a valid

Yes No
driving licence?
Do you have access
to a vehicle, which
you are able to use Yes No
for work purposes?

If ‘No’, are you able

to travel, for work
purposes, by another Yes No
means of transport?

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Page 6 / 19 Section 4 – Mobility
 5 Education and Qualifications
Secondary School Education
Please list most recent first and continue on a separate sheet if necessary.
A) School name Start date End date
KANJURI HIGH SCHOOL 1990 1994

Qualification/subject obtained & awarding body Grade Date

MATHS,ENGLISH,CHEMISTRY,BIOLOGY,PHYSICS,LIT, WOODWORK,
AVESWAHILI
B GEOGRAPHY
1994

B) School name Start date End date

Qualification/subject obtained & awarding body Grade Date

C) School name Start date End date

Qualification/subject obtained & awarding body Grade Date

D) School name Start date End date

Qualification/subject obtained & awarding body Grade Date

E) School name Start date End date

Qualification/subject obtained & awarding body Grade Date

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Page 7 / 19 Section 5 – Education and Qualifications
Further/Higher Education
College/University/Apprenticeships etc. Please list most recent first.
A) Educational establishment Start date End date
KENYATTA UNIVERSITY 1996 2000

Qualification/subject obtained & awarding body Level/Grade Date

BACHELORS OF EDUCATION MATHS AND BUSINESS STUDIES 2ND CLASS 2000

B) Educational establishment Start date End date

MIDDLESEX UNIVERSITY 2010 2012

Qualification/subject obtained & awarding body Level/Grade Date

POST GRADUATE DIPLOMA PASSS 2012

C) Educational establishment Start date End date

Qualification/subject obtained & awarding body Level/Grade Date

D) Educational establishment Start date End date

Qualification/subject obtained & awarding body Level/Grade Date

E) Educational establishment Start date End date

Qualification/subject obtained & awarding body Level/Grade Date

F) Educational establishment Start date End date

Qualification/subject obtained & awarding body Level/Grade Date

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Page 8 / 19 Section 5 – Education and Qualifications
Professional Qualifications
Including details of professional association membership

Do you hold Qualified Teacher

Yes No
Status (QTS)?
If Yes please complete the details below…

Your Teacher Reference Number 0531010

If qualified since August 1999 Start date Completion date

Your Statutory Induction Period 01/09/2006 31/07/2007

Other relevant training and development activities

attended in the last 5 years
Please list the most recent first and continue on a separate sheet if necessary.

A) Brief description/Course title

Organising Body Date

B) Brief description/Course title

Organising Body Date

C) Brief description/Course title

Organising Body Date

D) Brief description/Course title

Organising Body Date

E) Brief description/Course title

Organising Body Date

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Page 9 / 19 Section 5 – Education and Qualifications
 6 Information in support of
your application
Please use the Person Specification/Job Description as a prompt to describe the experience,
skills, competencies and qualifications that make you suitable for this job. These may have
been gained from your work experience, any voluntary or community work or any other
organisation you may have been involved with. You should ensure that any information
submitted reflects your experience relating to the competencies that are detailed in the
Person Specification/Job Description (please continue on a separate sheet if necessary).

If you are a teacher, please provide details of any specialist teaching experience/skills you
possess that may be relevant to the post.

Enthusiastic mathematics Teacher who has strong passion for student

development coupled with excellent communication skills and teaching
experiences. Proven leadership experience, organizational skills, and
communication abilities to effectively coach, support and develop teachers and
instructional teams. Works with each student individually
to achieve goals. Dedicated to creating a deep appreciation for mathematics in
students. Detail-oriented professional with highly professional attitude, problem
solving, strong leadership, relationship-building skills and ability to perform well in
a team. Looking for an opportunity in a dynamic organization where my skills will
be fully utilized.

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Page 10 / 19 Section 6 – Information in support of your application
 7 References
Please give the names, company name (where applicable) and addresses of your
two most recent employers (if applicable). If you are unable to do this, please
clearly outline who your referees are.

Referee 1 Referee 2
Name Name
ALEX EKWALLA ASHELY
Position Position
HEAD OF MATHS DIRECTOR
Company name Company name
GAINES HIGH SCHOOL EDUC8 EDUCATION SERVICES
Company address Company address
Brackendale Gardens, Essex, RM14 3UX 280 Mare Street, Hackney,
London E8 1HE

Telephone number Telephone number

+447958292567 020 8017 8629
Fax number Fax number

Email address Email address

[email protected] [email protected]
(i) Referees will be contacted before interviews unless otherwise requested (see below).

(ii) If either of your referees know you by another name please give details.

(iii) The Trust may contact other previous employers for a reference with your consent.

(iv) References will not be accepted from relatives or from people writing solely in the capacity of friends.

(v) If you are currently working with children, your current employer will be asked about disciplinary offences relating
to children, including any which the penalty is ‘time expired’ and whether you have been the subject of any child
protection concerns, and if so, the outcome of any enquiry or disciplinary procedure.

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Page 11 / 19 Section 7 – References
 8 Close Personal Relationships
Are you a relative or partner, or do you have a close personal
relationship with, any employee or Governor of the Osborne
Co-operative Academy Trust? (see notes below)

Yes No

(i) Failure to disclose a close personal relationship as above may disqualify you.

(ii) Canvassing of Governors or Senior Managers by or on your behalf is not allowed.

9 Statements and Declarations

Please read the following statements and information relating to your application
carefully. By signing and submitting this form, you are certifying that the
information you have supplied is accurate and confirming that the declarations are
true to the best of your knowledge.

Declaration
I certify that, to the best of my belief, the information I have provided is true and
I understand that any false information will result, in the event of employment, in
disciplinary investigation by the Trust, and is likely to result in dismissal.

Disclosure of Criminal Convictions

Preferred candidates will be asked to complete a Self-Disclosure Form (SD2) to
disclose whether they have:

• any unspent conditional cautions or convictions under the Rehabilitation of

Offenders Act 1974; or

• any adult cautions (simple or conditional) or spent convictions that are not
protected as defined by the Rehabilitation of Offenders Act 1974 (Exceptions)
Order 1975 (Amendment) (England and Wales) Order 2020.

The amendments to the Rehabilitation of Offenders Act 1974 (Exceptions) Order

1975 (2013 and 2020) provides that when applying for certain jobs and activities,
certain convictions and cautions are considered ‘protected’. This means that they
do not need to be disclosed to employers, and if they are disclosed, employers
cannot take them into account. Guidance notes are available to accompany the…

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Page 12 / 19 Section 8/9 – Close personal relationships / Statements and Declarations
 SD2 form to assist candidates with information which must be disclosed. Any
information disclosed will be treated in the strictest confidence.

Where appropriate for the role, a disclosure/status check will be sought from the
Disclosure and Barring Service (DBS) in the event of a successful application. A
person’s criminal record will not in itself be a bar to obtaining employment, save in
the case of management positions where a S128 Direction issued by the Secretary
of State will prohibit employment.

Safer recruitment and Childcare

Disqualification Checks
I certify that I am not disqualified from working with children or subject to
sanctions imposed by a regulatory body, which would prohibit or restrict me from
applying for this post.

Preferred candidates applying for a relevant post in a school setting covered by the
Childcare (Disqualification) Regulations 2018 (“the Regulations”) will be asked to
complete a Disqualification Declaration Form.

A disqualified person may only be employed in a relevant post if they obtain a

waiver from Ofsted. A copy of the Disqualification Declaration Form is available
from the schools HR Officer/Trust HR Officer if you wish to review this form prior
to submitting your application

Data Protection Legislation

I hereby give my consent for personal information (including recruitment
monitoring data) provided as part of this application to be collected, held and
processed in accordance with the Trust’s data protection policy and record
retention schedule.

Correspondence
Thank you for applying for this post. Your interest in working with us is very much
appreciated. It is not practice to acknowledge receipt of applications. If you wish
to be informed of the outcome of your application once the selection process has
been completed, please let us know when you submit the form digitally, or enclose
a stamped addressed envelope if you are posting it to us.

* Check the box (left) to certify that the information Date*

supplied in this form is accurate and confirm that the
declarations are true to the best of your knowledge. 05/05/2024

Signed* * Required before submission

JACKSON HOME

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Page 13 / 19 Section 9 – Statements and Declarations
 10 Recruitment Monitoring
Information
Osborne Co-operative Academy Trust is an equal opportunity employer committed
to ensuring that applicants are selected on the basis of their abilities relevant
to the job. The aim of our policy is to ensure that no job applicant or employee
receives less favourable treatment because of age, disability, gender reassignment,
marriage and civil partnership, pregnancy or maternity and race.

The information you provide will be used for monitoring and statistical data
purposes only and will not be seen by the short-listing panel. This section will be
detached from your application form prior to short-listing. If you do not wish to
share this information, you can select the ‘prefer not to say’ option.

Job appointment title TEACHER OF MATHS

Your first name(s) JACKSON

Your last name HOME

1. Your age 15–19 20–24 25–29

30–34 35–39 40–44

45–49 50–54 55–59

60–64 65–69 70+

Prefer not to say

2. Your gender Male Female

Prefer not to say

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Page 14 / 19 Section 10 – Recruitment monitoring information
3. Your ethnic origin (If ‘Other’ please specify)
Asian/Asian British–Bangladeshi Mixed–White and Asian

Asian/Asian British–Indian Mixed–White and Black African

Asian/Asian British–Pakistani Mixed–White and Black Caribbean

Asian/Asian British–Other Mixed–Other

Chinese–Chinese White–British

Black/Black British–African White–Irish

Black/Black British–Caribbean White–Other

Black/Black British–Other Other…

Prefer not to say

4. Do you have a disability?

You will be considered as having a disability for
I do consider myself to have a disability as discrimination purposes if you fit the definition as given
in the Equality Act 2010. In the Act, a disability is a
defined by the Equality Act 2010
‘physical or mental impairment which has a substantial
I do not consider myself to have a disability and long-term adverse effect on a person’s ability
to carry out normal day-to-day activities’. For these
as defined by the Equality Act 2010 purposes, ‘long-term’ is taken to mean the condition is
likely to last longer than 12 months or likely to recur.
Prefer not to say

5. Data protection statement

Data Controller Name: Osborne Co-operative Academy Trust

Osborne Co-operative Academy Trust uses this information to review compliance with its policies on equal opportunity
in relation to recruitment. We will use this data to inform our statistics on the representation of the categories of
individual as shown above. We will treat all personal information in line with current data protection legislation and our
data protection policy. For more information on how we use the information you have provided, please see our privacy
notice for job applicants, which is attached to this form.

In order for us to process this information and to comply with data protection legislation, we require your consent. You
are not required to give your consent; you acknowledge that any consent given is freely given. Your job application is
not dependent on your giving consent to our processing of this data.

Including your signature below will signify your consent to our processing of this information. Once you have given
consent, you may withdraw it at any time by contacting Osborne Co-operative Academy Trust at [email protected]

Signed* * Required before submission Date*

JACKSON HOME 05/05/2024

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Page 15 / 19 Section 10 – Recruitment monitoring information
 11 Privacy Notice: Applicants
Please be advised that not all of this data is shared with everyone listed. We only
share data required for that particular function and only the minimum required.

What is the service being Recruitment of School Staff – Applicants

provided?

What personal data do we • Name

need from you? • Address
• Date of Birth
• Contact details, including email and phone number
• National Insurance Number
• Employment History, including reason for leaving
• Current level of Pay and any Allowances
• Pre-employment check information, including entitlement to
work in the UK and Criminal Record Checks
• History of sickness absence from previous employer
• Reference and Referees contact details
• Qualifications/skills/Experience, including Secondary School
Education and Continuing Education and Professional
Qualifications
• Breaks in employment history
• Ability to travel
• Training & Development History
• Close Personal Relationship information
• Disability information to enable us to make reasonable
adjustments

Who will be using your Who is the Data Controller? Osborne Co-operative Academy Trust
Personal Data?
Who is the Data Controller’s Lauri Almond
Data Protection Officer? (Essex County Council).

Are there any Data Yes

Processors?

Who are they? Members of the HR and Recruitment

team, Interviewers, relevant
Governors and Trustees, Legal
Services contracted by the school.

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Page 16 / 19 Section 11 – Privacy Notice: Applicants
What will it be used for The Purpose(s) Recruitment
and what gives us the
right to ask for it and use
The Legal Condition(s) • Under Contract
it? • Employment, Social Security

Who else might we share HR, Legal, Trustees and Governors, CEO/Headteacher/Head of
your data with? School

Will your data be stored No

in or accessible from
countries with no UK-
equivalent Privacy Law
protections?

How long will your data When will it stop being used? Unsuccessful candidates
be kept? 6 months from the date of the
appointment of the successful
candidate.
Successful candidates
Data will be held in line with the
Trust’s Data Retention Schedule.

How long after this will it be Unsuccessful candidates

deleted? 6 months from the date of the
appointment of the successful
candidate.
Successful candidates
Data will be held in line with the
Trust’s Data Retention Schedule.

Our use of the data will be

subject to your legal rights  Inform  Access  Rectify  Erase  Object

As you are giving us your This is the reason why we are • Contract Law
data directly… allowed to ask for it and use it: • Eligibility to work in the UK
• Keeping Children Safe in
Education 2019 (As Updated).

This is what could happen if Unable to process application/

you refused to let us use your continue with recruitment process
data for this purpose:

This is who is giving us your Basic Demographics, e.g. name,

personal data: address, Date of Birth, Contacts,
references from previous employers,
employment suitability/safeguarding
checks, prohibition, right to work and
qualifications checks

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Page 17 / 19 Section 11 – Privacy Notice: Applicants
As you are not giving your This is who is giving us your Previous employer/s, DBS service,
personal data: The Teaching Regulation Agency,
data directly to us… Overseas Embassies

This is a source of personal No

data open to anyone:

These are the categories of Basic Demographics, e.g. name,

personal data being given address, Date of Birth, Contacts,
references from previous employers,
to us: employment suitability/safeguarding
checks, prohibition, right to work and
qualifications checks

Visit the following links for more information about privacy law, our obligations
and your rights:

The ICO Guide to the General Data Protection Regulations 2018

https://ico.org.uk/for-organisations/guide-to-data-protection/guide-to-the-general-data-
protection-regulation-gdpr/

The General Data Protection Regulations 2018

https://www.gov.uk/data-protection

If you have concerns over the way we are asking for or using your personal data,
please raise the matter with our Data Protection Officer by the following means:

Postal Address: Essex County Council,

County Hall,
Chelmsford.
CM1 1QH

Email Address: [email protected]

Phone Number: 0333 032 2970

If you still have concerns following our response you have the right to raise the
matter with the Information Commissioner’s Office:

Postal Address: Information Commissioner’s Office,

Wycliffe House, Water Lane,
Wilmslow, Cheshire.
SK9 5AF

Online Form: https://ico.org.uk/concerns/handling/

Phone Number: 0333 032 2970

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Page 18 / 19 Section 11 – Privacy Notice: Applicants
 12 How to submit your form
Important: Before doing any of the following, insure that you have saved
your completed form.

Submitting your form Apple iPhone / iPad

digitally from a mobile 1. Open the Mail App;
phone, tablet, laptop or 2. Compose a new email;
desktop devise 3. Tap in the email where you want to insert your completed
PDF form, then tap above the keyboard.
4. Tap above the keyboard, then locate the document in Files.
5. In Files, tap Browse or Recent at the bottom of the screen,
then tap a file, location, or folder to open it.
6. Send your email and attached file to: [email protected]

Android phone / tablet

1. Open the Gmail app;
2. Tap Compose;
3. Tap Attach;
4. Tap Attach file or Insert from Drive;
5. Choose your saved PDF form file;
6. Send your email and attached file to: [email protected]

Laptop / Desktop devise

1. Open your prefered email application;
2. Compose your email and attached your saved PDF form file;
3. Send your email and attached file to: [email protected]

Submitting a completed You can print your digitally completed form by using the ‘Print’
printed form button below.

Please post it to the address below ensuring plenty of time for it

to arrive before the closing date.

Att: Human Resources Team

Osborne Co-operative Academy Trust
Butts Lane,
Stanford-le-Hope,
Essex. SS17 0NW

< Back Print your application form

Page 19 / 19 Section 12 – How to submit your form