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Hill House School
APPLICATION FOR EMPLOYMENT
1. PERSONAL DETAILS
POST APPLIED FOR
Surname (block capitals) Previous surname (if applicable) Title (Mr, Ms, Mrs, Miss, Dr etc) Other names in full National Insurance No Address Telephone numbers Home Work Mobile Post code E-mail
Do you hold a clean current driving licence? YES/NO DfEE Reference Number (applicants for teacher posts)
2. EDUCATION AND QUALIFICATIONS
SCHOOLS ATTENDED AND DATES:
COLLEGE/UNIVERSITY ATTENDED AND DATES:
3. EMPLOYMENT DETAILS - CURRENT EMPLOYMENT
Post held Employer Address Full or part time Date appointed Current Salary/Responsibility Point Notice required to terminate Outline of current duties and responsibilities. (Continue on a separate as sheet if necessary.)
PREVIOUS EMPLOYMENT - Please list your full time and part time occupations.
Name of Employer Post held Dates FT / PT Reason for leaving
PLEASE CONTINUE ON A SEPARATE SHEET AS NECESSARY
4. TRAINING AND DEVELOPMENT
Please provide details of any relevant training you have undertaken in the last 3 years.
5. Please indicate any further information about yourself, career or interests which you feel will support your application.
6. INTERESTS (e.g. music, sports etc)
7. DISCLOSURE OF CRIMINAL BACKGROUND OF THOSE WITH ACCESS TO CHILDREN
Due to the nature of the work for which you are applying, this post is exempt from the provisions f section 4(2) of the REHABILITATION OF OFFENDERS ACT 1974 by virtue of the Rehabilitation of Offenders Act 1974 (Exemptions) Order 1975 as amended by the (Exceptions) (Amendment) Order 1986, and will require a police check to be undertaken. You are required to disclose any information you may have regarding any convictions against yourself regardless of when they occurred (which would otherwise be considered as “spent” in relation to this application). Any such information will be treated in strictest confidence and used only in consideration of the suitability of your application.
Have you been convicted of a criminal offence? YES NO
If YES please give details
8. DISCLOSURE BY ASSOCIATION
To the best of your knowledge, is anyone in your household* disqualified from working from working with children under the Regulations?
*household – includes family, lodgers, house-sharers, household employees
This means does anyone in your household have an Order or Restriction against them as set out in Section 1 of the Childcare Disqualification Regulations or have they been cautioned, reprimanded, given a warning for or convicted of any offence in Section 2 of the same act.
9. REFEREES Please supply names, addresses and telephone numbers of two people to whom reference may be made, one of whom should be your most recent employer. The school may contact any previous employer.
Do you object to these being contacted prior to invitation to interview? YES NO
Name Name Occupation Occupation Address Address Post code Post code Telephone: Telephone: Email: Email: Fax: Fax:
I declare that to the best of my knowledge and belief, all statements contained in this form are correct and I understand that should I conceal any material fact, I will, if engaged, be liable to the termination of my contract of employment.
Note: Interview expenses will not be refunded to a candidate who declines a post which has been offered, or withdraws his/her candidature after interview.
EQUAL OPPORTUNITIES MONITORING
The School is committed to a policy of equality of opportunity. The aim of the policy is to ensure that no job applicant or employee should receive less favourable treatment on grounds of ate, race, nationality, ethnic origin, religion, belief, on-belief, disability, sexual orientation, gender, marital or parental status, political belief or social or economic class, or any other criteria which cannot be shown to be justifiable.
In order to monitor the impact of this policy, it is necessary to collect information from all employees and job applicants on the key factors which relate to equality and diversity in employment. The information provided on this form will not be used in the selection process. The data will be used in an anonymous format to provide statistical information that will enable the school to monitor the effectiveness of its policies and procedures.
Are you: Male Female
Date of Birth:
Job Title: Reference Number:
How did you first become aware of this vacancy?
Newspaper/Journal – please specify
Website – please specify
Other – please specify
What is your country of legal nationality?
Do you require a work permit to work in the UK? Yes No
How would you describe your ethnic origin?
White – British Chinese White – Irish Other Asian background Other white background Mixed – White and Black Caribbean Black or Black British –Caribbean Mixed – White and Black African Black or Black British-African Mixed – White and Asian Other Black background Other mixed background Asian or Asian British – Indian Other Ethnic background Asian or Asian British – Pakistani Information refused Asian or Asian British – Bangladeshi
Do you have any medical condition which could significantly affect your performance of the duties of the post for which you are applying? (please tick) Yes No
If you answered Yes,
please give brief
Please indicate the number of days absent from work due to illness in the last 12 months days
Reasons for illness.
Please note that you may be required to complete a medical questionnaire and/or consent to a medical examination.
Under Disability Discrimination Act 1995, employers are required to provide people with disabilities with an opportunity to compete fairly for jobs and be given equal opportunities as far as practical in employment. The School uses the following definition for the term disability: “a physical or mental impairment which has a substantial and long-term adverse effect on a person’s ability to carry out normal day-to-day activities”.
Do you consider yourself to have a disability? Yes No
If I am appointed to the post for which I am applying, I agree that the information on this form may be stored and used in monitoring the School’s Equal Opportunities Policy, in accordance with the provisions of the Data Protection Act 1998.
Skk/Masters/App for Employ support staff/Nov 06
Office Use Only
“Hill House School is an equal opportunities employer and is committed to protecting and safeguarding the interests of children”.