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Trinity School and College

March 20, 2020
Trinity School and College

Application Form

Application : Form
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Position applied for

 

Title  

 

Surname First Name/s
Previous Surname Preferred Name
Date of Birth National Insurance Number
Current Address Home Telephone Number
Mobile Telephone Number
Email Address
 

Teaching Applications only

DfE Number GTCE registration YES/NO

 

Are you related to any member of Trinity School and College Staff or a Student either Past or Present? YES/NO
If yes, please provide details

 

 

References References will be taken up before an offer of employment and may be taken up prior to interview.  One reference must be your current or last employer.
Name Name
Status/Role Status/Role
Address Address
Email address Email Address  
Telephone Numbers Telephone Numbers
Secondary education, further and higher education and Qualifications [original documentation of qualifications will be required as evidence prior to an appointment]  please start at the most recent
Dates attended Secondary School, College, university or other institution Qualifications title including grade/level
From mm/yy To mm/yy

 

 

In Service Training and Development over the past two years
Academic year Name of Provider Duration Title of Course

 

Other Skills and Interests (please include languages, use of computers, team working, problem solving)
 

 

 

 

 

 

 

 

 

Employment History [original documentation of qualifications will be required as evidence prior to an appointment]  please start at the most recent
Name and Address  of Employer Employment Period

MM/YY – MM/YY

Job Title Salary Key Responsibilities Reason for Leaving
 

 

         
 

 

         
 

 

 

         
 

 

 

         
 

 

 

         
 

 

 

         
 

 

 

         
 

 

 

         
 

 

 

         

 

 

Personal Statement
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Data

 

Are there any restrictions to your residence in the UK which might affect your right to take up employment in the UK? YES/NO
If Yes, please provide details below
 

 

If you are successful in your application, would you require a work permit prior to taking up employment? YES/NO
If Yes, please provide details below
 

 

Data Protection Statement
I hereby give my consent for Trinity School and College to which this application relates to process and retain on file information (including health and ethnic data) contained on this form and in accompanying documents. This is required for recruitment purposes, the payment of staff and the prevention and detection of fraud. This information may be shared with third party organisations including, but not exclusive to, payroll providers, the DBS, the police and other third parties as defined by the GDPR and related legislation. All information will be dealt with in accordance with GDPR legislation.

 

 

 

I declare that the information I have given in this application is accurate and true. I understand that providing misleading or false information will disqualify me from appointment OR, if appointed, may result in my dismissal. YES/NO
Signature Date

 

 

Please return your completed application form to the above address or by email to

business@trinityschoolrochester.co.uk

 

 

CONFIDENTIAL

 

This section of the form is CONFIDENTIAL and will be detached from your application prior to interview.  Trinity School and College recognises and actively promotes the benefits of a diverse workforce and is committed to treating all employees with dignity and respect regardless of race, gender, disability, age, sexual orientation,

religion or belief. We therefore welcome applications from all sections of the community.

 

Ethnic Group

 

Please tick Ethnic Group

*Please specify

White       British       Irish

 

Any other White background* ___________________________________

 
Mixed    White & Black Caribbean      White & Black African     White & Asian

 

Any other Mixed background* ___________________________________

 
Black or Black British       Caribbean     African

 

Any other Black background* ___________________________________

 
Asian or Asian British       Indian       Pakistani      Bangladeshi

 

Any other Asian background* ___________________________________

 
Chinese or Other Ethnic Group     Chinese

 

Other Ethnic Group* ___________________________________

 

If you wish you may disclose information about yourself in this section about your:
Religion/Beliefs
Sexual Orientation

 

 

Disability Statement
Trinity School and College aims to be a fair employer and is committed to equal opportunity for disabled people.  Applications from disabled people are welcome.
Please answer the following questions:
1. Do you consider yourself to be disabled? YES/NO
If YES, do you consider yourself to be disabled under the terms of the Disability Discrimination Act? YES/NO
The Disability Discrimination Act 1995 defines disability as ‘a physical or mental impairment which has a substantial and long-term adverse effect on an individual’s ability to carry out normal day-to-day activities.’
2. Is there anything you would particularly like to tell us about your disability?
 

 

 

 

Declaration

I declare that, to the best of my knowledge, I know of no reasons, on grounds of mental or physical health, why I should not be able to discharge the responsibilities required by the role I am applying for.

I understand that the School is legally required to verify my medical fitness for the role and that my employment with the School is therefore conditional upon my being medically fit to carry out the duties required by the role.

I understand that failure to disclose any relevant information now, or giving false information, may result in the termination of my employment or the withdrawal of an offer of employment.

I consent to the School retaining this medical declaration and any other information about my medical fitness on my confidential personnel file for the duration of my employment.

I understand and agree that the School may use any medical information held about me to help discharge its obligations towards me as my employer as and when it is necessary, or reasonable, to do so.

I understand and agree that the School may confidentially retain any medical information about me for a period of six months after my employment terminates, following which it will be securely destroyed.

I understand and accept that, should my health circumstances change during the course of my employment such that I am (or am likely to become) not able to discharge the responsibilities required by my role, I shall inform the school without delay.

I hereby give my consent to Trinity School and College processing the data supplied above.

The information I have provided on my impairment or health condition is correct to the best of my knowledge and belief.

 

Signed:

 

Date:

 

 

 

School Staff Disqualification Declaration – CONFIDENTIAL

 

 

Name Post

 

Please circle one answer for each question
Protection of children
The amendments to the Exceptions Order 1975 (2013) provide that certain spent convictions and cautions are ‘protected’ and are not subject to disclosure to employers , and cannot be taken into account. Guidance and criteria on the filtering of these cautions and convictions can be found on the Disclosure and Barring Service website. See relevant links below.
Section 1 Orders or other restrictions
Have any orders or other determinations related to childcare been made in respect of you? YES/NO
Have any orders or other determinations related to childcare been made in respect of a child in your care? YES/NO
Have any orders or other determinations been made which prevents you from being registered in relation to child care, children’s homes or fostering? YES/NO
Are there any other relevant orders, restrictions or prohibitions in respect of you as set out in the Schedule 1 of the Regulations? Available at the link below:

http://www.legislation.gov.uk/uksi/2009/1547/schedule/1/made

YES/NO
Are you barred from working with Children by the Disclosure and Barring Service (DBS)? YES/NO
Are you prohibited from teaching by the National College for Teaching & Leadership (NCTL)? YES/NO
Section 2 Specified and Statutory Offences

 

Have you ever been cautioned, reprimanded, given a warning for or convicted of:
Any offence against or involving a child? (A child is a person under the age of 18) YES/NO
Any violent or sexual offence against an adult?

 

YES/NO
Any offence under the Sexual Offences Act?

 

YES/NO
Any other relevant offence? YES/NO
Further information available at the links below:

http://www.legislation.gov.uk/uksi/2009/1547/schedule/2/made

http://www.legislation.gov.uk/uksi/2009/1547/schedule/3/made

Have you ever lived or worked abroad YES/NO
Have you ever been cautioned, reprimanded, given a warning for or convicted of any similar offence in another country?

 

 

YES/NO
Section 4 Provision of Information

 

If you have answered YES to any of the questions above you should provide details the below in respect of yourself, or where relevant the member of your household. You may supply this information separately if you so wish, but you must do so without delay. YES / NO
Details of the order, restriction, conviction, caution etc. including dates  and relevant court(s) body(ies) (give details below)

 

 

You must also provide a copy of the relevant order, caution, conviction etc. In relation to cautions/convictions a DBS Certificate may be provided.
Section 4 – Declaration

 

In signing this form, I confirm that the information provided is true to the best of my knowledge and that:
·       I understand my responsibilities to safeguard children.

·       I understand that I must notify my head teacher immediately of anything now or in the future that affects, or might affect, my suitability to work in the School, including any cautions, warnings, convictions, orders or other determinations made in respect of me or a member of my household that would render me disqualified from working with children under the Childcare (Disqualification) Regulations 2009, replacement or similar legislation. Failure to notify will be a serious matter, considered as gross misconduct under the Disciplinary processes and could result in summary dismissal.

 

Signed  

 

Date  
Print Full Name  

 

 

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