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The Bishop of Winchester Academy

The Bishop
of Winchester

Teaching Staff Application Form

Part A - 1. Applicant's Personal Details

Are there any restrictions on your being resident or being employed in the UK?*

2. Education and Training

 Name of Institute and AddressFromToExaminations passed with grades
Secondary School or College:
University of College:
PGCE Institute attended (if applicable):
Post Graduate Study:
NPQH (if applicable):

3. Inservice Training/Professional Development

 TitleOrganising BodyFromTo
 TitleOrganising BodyFromTo

4. Employment Record (please list current employment first) Please ensure there are no gaps in employment history (if there has been a break for any reason please advise)

 Name and address of employerIf a school Number on rollAge range of schoolJob title and salaryFull/part timeToFromReason for leaving

5. Employment other than teaching

 Name of organisationJob TitleFromTo

6. Current Salary

7. Professional References - please give the names of two referees who can vouch for your professional work, one of whom should be your present employer.

Please contact me prior to reference being taken up:*
Please contact me prior to reference being taken up:*

8. Supporting Statement - Your application should be supported by a letter of not more than 2 sides of A4 (12pt), addressing the criteria in the person specification for this post.

9. Leading and Teaching in a Church of England School or Academy - We welcome people of many faiths and beliefs. We do, however, ask that all staff should support the values, ethos and philosophy of a Christian school, in the tradition of the Church of England, and we would expect staff to make a positive contribution to the development of that Christian ethos. We expect our school leaders to demonstrate a clear commitment to the Christian ethos. If you are a practising member of a Christian Church, please give details:

Part B - Confidential Information (This section of the form will be removed before shortlisting.)

3. Ethnicity form: A White
B Mixed
C Asian, Asian British, Asian English, Asian Scottish, or Asian Welsh
D Black, Black British, Black English, Black Scottish, or Black Welsh
E Chinese, Chinese British, Chinese English, Chinese Scottish, Chinese Welsh, or other ethic group
4. Criminal History. As this post is classified as having substantial access to children, appointment will be subject to a police check of previous criminal convictions. You are required, before appointment, to disclose any conviction, caution or binding over including ‘spent convictions’ under the Rehabilitation of Offenders Act 1974 (Exemptions) Order 1975. Non disclosure may lead to termination of Employment. However, disclosure of a criminal background will not necessarily debar you from employment – this will depend on the nature of the offence(s) and when they occurred. Have you ever been convicted of a criminal offence?*

5. Work Status. I understand that under the terms of the Asylum and Immigration Act 1996 should I be short-listed for the post for which I am applying, I will provide for the governing body, as employer, an original document* showing my entitlement to work in this country. *Acceptable documents include your National Insurance card, a birth certificate issued in the UK or Eire, a P45 from your previous employer, a valid passport, or any relevant authorisation allowing you to work in this country.

6. Other information. Are you related to any member of the governing body, LA elected member, senior LA official or officer of LDBS?*
  • Duke of Edinburgh
  • Diocese of Winchester