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The Bishop
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Support Staff Application Form
Support Staff Application Form
Application form for:
*
Part A - 1. Applicant's Personal Details
Surname:
*
Fornames:
*
Title (Mr, Mrs, Ms etc.)
*
Previous Name(s): (if applicable)
Address:
*
Email Address:
*
Home Telephone:
*
Mobile:
*
National Insurance Number:
*
If you are selected for interview, how would you like to be contacted?
*
Email
Letter
Phone
Are there any restrictions on your being resident or being employed in the UK?
*
Yes
No
2. Education and Training
*
Name of Institute
From
To
Examinations passed with grades
3. Other Training/Short Courses
Course Title
From
To
4. Employment Record (Please list most recent employment first)
*
Employers Name and Address
Job Title and brief description of duties
Date from/to
Reason 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.)
i) Name:
*
Position:
*
Address:
*
Telephone number:
*
Email address (where possible):
ii) Name:
*
Position:
*
Address:
*
Telephone number:
*
Email address (where possible):
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.)
1. Gender:
*
2. Cultural/ethnic origin:
*
3. Ethnicity form: A White
British
English
Scottish
Welsh
Irish
Any other White background, please write in
B Mixed
White and Black Caribbean
White and Black African
White and Asian
Any other Mixed background, please write in
C Asian, Asian British, Asian English, Asian Scottish, or Asian Welsh
Indian
Pakistani
Bangladeshi
Any other Asian background, please write in
D Black, Black British, Black English, Black Scottish, or Black Welsh
Caribbean
African
Any other Black background, please write in
E Chinese, Chinese British, Chinese English, Chinese Scottish, Chinese Welsh, or other ethic group
Chinese
Any other background, please write in
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?
*
Yes
No
If yes, give details:
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?
*
Yes
No
If yes, please give details:
b. If you are shortlisted for an interview, please could you let us know in advance if you require any adjustments because of a disability?
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.
Should you not want us to hold and pass on your details within the Academy please tick
Signature:
*
Date:
*
Submit