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Teaching Staff
1
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Application for the post of
(Required)
Select a Post
Early Years Leader and Reception Class Teacher - Harefield Primary School
Classroom Teacher - EYFS/KS1 - Shirley Infant School
KS1 Teacher (Year 1 or 2) - The Hollybrook Schools
KS2 Class Teacher - The Hollybrook Schools
Class Teacher - Westover Primary School
KS1 Class Teacher (Maternity Cover) - The Hollybrook Schools
Class Teacher - Wordsworth Primary School
Advertised at school
(Required)
Applicant's details
(Required)
First
Last
Any other last names
Title
(Required)
Address
(Required)
Field Hiden
Postcode
(Required)
Day time contact no.
(Required)
Evening / Mobile no
(Required)
Email address
(Required)
Secondary / Further Education
Name of school / college 1
Date From 1
DD slash MM slash YYYY
Date To 1
DD slash MM slash YYYY
Subject and Qualification 1
Grade and date awarded 1
Establishment (Name & town) 2
Date From 2
DD slash MM slash YYYY
Date To 2
DD slash MM slash YYYY
Subject and Qualification 2
Grade and date awarded 2
Name of school / college 3
Date From 3
DD slash MM slash YYYY
Date To 3
DD slash MM slash YYYY
Subject and Qualification 3
Grade and date awarded 3
Establishment (Name & town) 4
Date From 4
DD slash MM slash YYYY
Date To 4
DD slash MM slash YYYY
Subject and Qualification 4
Grade and date awarded 4
Higher Education and Courses leading to other relevant qualifications
Higher Education: Establishments attended 1
Date From 1
DD slash MM slash YYYY
Date To 1
DD slash MM slash YYYY
Qualification obtained and date of award 1
Subjects Main 1
Subjects Subsidiary 1
Higher Education: Establishments attended 2
Date From 2
DD slash MM slash YYYY
Date To 2
DD slash MM slash YYYY
Qualification obtained and date of award 2
Subjects Main 2
Subjects Subsidiary 2
Higher Education: Establishments attended 3
Date From 3
DD slash MM slash YYYY
Date To 3
DD slash MM slash YYYY
Qualification obtained and date of award 3
Subjects Main 3
Subjects Subsidiary 3
Higher Education: Establishments attended 4
Date To 4
DD slash MM slash YYYY
Dates To 4
DD slash MM slash YYYY
Qualification obtained and date of award 4
Subjects Main 4
Subjects Subsidiary 4
School/College/ Establishment
(Required)
Local Authority (if applicable)
(Required)
Number on roll
(Required)
Post Held
(Required)
(If part-time, please give details)
(Required)
Date appointed
(Required)
DD slash MM slash YYYY
Subjects, age groups taught and other responsibilities
(Required)
Notice required and / or date available if appointed
(Required)
Current gross salary and pay range
(Required)
Please give details of any allowance you may receive
(Required)
Previous experience
Local Education Authority and School/College 1
Type of School 1
No. on roll 1
Age Range 1
Status of Post, subjects taught 1
Reason for Leaving 1
Inclusive Period (month & year) 1
Local Education Authority and School/College 2
Type of School 2
No. on roll 2
Age Range 2
Status of Post, subjects taught 2
Reason for Leaving 2
Inclusive Period (month & year) 2
Local Education Authority and School/College 3
Type of School 3
No. on roll 3
Age Range 3
Status of Post, subjects taught 3
Reason for Leaving 3
Inclusive Period (month & year) 3
Local Education Authority and School/College 4
Type of School 4
No. on roll 4
Age Range 4
Status of Post, subjects taught 4
Reason for Leaving 4
Inclusive Period (month & year) 4
Other paid employment (including Service in H.M. Forces, industry). State responsibilities and reasons for leaving. Please indicate details of gaps in employment here
(Required)
Statement in support of application
(Required)
Statement in support of application cont.
(Required)
Statement to illustrate how your experience meets the threshold criteria of the school - (relevant only if the post for which you are applying sits on the Upper Pay Range).
(Required)
Confidential References (Please ensure referees know this reference is being requested)
Names, addresses and status of two referees (one of whom, if employed, must be your present manager e.g. your Headteacher). References will be sought on short listed candidates and previous employers may be contacted to verify particular experience or qualifications before interview. Current or previous employers will be asked about disciplinary offences relating to children including penalties that are “time expired” and any child protection concerns.
Present employer
Name
Address
Tel No (inc. STD code)
Email address
Occupation
Other
Name
Address
Tel No (inc. STD code)
Email address
Occupation
National insurance number
(Required)
Teacher Reference Number
(Required)
Qualified Teacher Status?
(Required)
YES
NO
Date
DD slash MM slash YYYY
Statutory induction year completed (if qualified after 7 May 1999)?
(Required)
YES
NO
Date
DD slash MM slash YYYY
Would you require sponsorship (previously a work permit) to take up this post?
(Required)
YES
NO
Date
DD slash MM slash YYYY
Where did you see the advertisement for this post?
(Required)
Canvassing in any form may disqualify you from employment. Please state whether, to the best of your knowledge, you are related to a governor or senior employee of the school or Trust
(Required)
YES
NO
If YES, please state the nature of relationship and the name of the governor or senior employee.
Nature of relationship
Signature of Candidate
(Required)
Date
DD slash MM slash YYYY
Equality Monitoring Form
We would be grateful if you would complete the following in order for us to monitor equalities information and ensure that we are treating all candidates fairly and appropriately. This information will be treated confidentially and will not be used in any part of the selection process.
School:
(Required)
Post applied for:
(Required)
Name
(Required)
First
Last
Date of Birth:
(Required)
DD slash MM slash YYYY
Gender Identity
(Required)
Female
Male
Transgender (M-F)
Transgender (F-M)
Intersex
Gender neutral
Non-binary or you choose to define your gender in another way
Sexual Orientation
(Required)
Heterosexual (straight)
Gay woman / Lesbian
Bisexual
Gay man
Other
Prefer not to say
Nationality
(Required)
British
Irish
Other EU country
Other non-EU country
Ethnicity
(Required)
British
White & Black Caribbean
Indian
Irish
White & Black African
Pakistani
Other white background
White & Asian
Bangladeshi
Caribbean
Other Mixed background
Other Asian background
African
Chinese
Other Black background
Any other background
I do not wish to disclose my ethnic origin
*Please indicate any other ethnic background:
Do you consider yourself to have a disability?
(Required)
Yes
No
I do not wish to disclose my disability data to the school or Trust
CAPTCHA
Comments
This field is for validation purposes and should be left unchanged.
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