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The Bishop of Winchester Academy

The Bishop
of Winchester
Academy

Support Staff Application Form

Part A - 1. Applicant's Personal Details
If you are selected for interview, how would you like to be contacted?*
Are there any restrictions on your being resident or being employed in the UK?*

2. Education and Training

*
 Name of InstituteFromToExaminations passed with grades

3. Other Training/Short Courses

 Course TitleFromTo

4. Employment Record (Please list most recent employment first)

*
 Employers Name and AddressJob Title and brief description of dutiesDate from/toReason for leaving

5. Professional References (Please give the names of two referees who can vouch for your professional work, one of whom should be your present employer.)

6. Supporting Statement - Your application should be supported by a letter of not more than 1 side of A4 (12pt), outlining how you feel you meet the criteria in the Person Specification.

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. a) Are you related to any member of the governing body, LA elected member, senior LA official or officer of LDBS?*
Declaration. To the best of my knowledge the information on this form is correct. I am in possession of certificates, which I claim to hold. I understand that willful falsification or omissions may, if I am appointed, result in my dismissal. You are reminded that any canvassing direct or indirect will disqualify candidates. Successful candidates may be required to produce their birth certificate and original proof of qualifications. I declare that I am not on List 99 or disqualified from working with children. I am not subject to any sanction imposed by the General Teaching Council. I consent to The Bishop of Winchester Academy processing the information given on this form, including 'sensitive' information, as may be necessary during the recruitment and selection process. I understand that if my application is unsuccessful this application may be held on file for a maximum of 6 months and where appropriate, my details may be passed onto other line managers. I understand that if I have sent this application form via e-mail it will automatically be deemed that I have signed the declaration below.
  • Diocese of Winchester

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