Application Form – Non-teaching position

Please complete the application form and recruitment monitoring form and return by email to the email address shown on the job advert.

If you have any queries please contact us – contact details are provided on the job advert.

Guidance on completing this form can be found in the document ‘Guidance on Completing your Application Form’.

1a. Job details	1b. Guaranteed interview for people with disabilities
(Please complete this section from information on the job advert) Job title: Job reference: Closing date:	Do you consider yourself to be a disabled person? Y / N
If yes, do you require any support or adjustments to enable you to take part in the selection process for this job? Y / N
If yes, please give details:
People with disabilities who meet the essential criteria will be guaranteed an interview.

2. Personal Details
Title:	Contact details:
Surname: Initial(s): Address:	Mobile number: Home number: E-mail:
Postcode:	National insurance no:

3. Education / Qualifications (most recent first)
School/college/ university/placement	From	To	Courses taken/ qualifications	Grade / Outcome	Date
(For written applications, please continue on a separate sheet if necessary)
Are you currently a member of any professional bodies? Y / N If so, please state name of body: Level of membership attained: Membership No: Are you registered for CPD (Continuous Professional Development)? Y / N

Present employment
Name and address of present employer:	Job title:
Gross salary/wage:
Date of appointment:
Notice period:
Brief details of duties and responsibilities: (For written applications, please continue on separate sheet if necessary)

Past employment (paid or unpaid) – most recent first
Employer’s name (and address if appropriate)	Position held	Dates (month/year)
From	To

Relevant training courses attended – most recent first
Organising body	Course details	Dates (month/year)
From	To
(For written applications, please continue on a separate sheet if necessary)

7. Experience & Additional Information
Please give reasons for making this application. See document “Guidance on Completing your Application Form.” (For written applications, please continue on a separate sheet if necessary)

8. Job share
Are you applying as a job sharer? Y / N

9. Relationships
Are you related to any Director, Governor or employee of St Bartholomew’s CE MAT? Y / N
If yes, please state who:
Please note: Canvassing of members or officers of St Bartholomew’s CE Multi Academy Trust directly or indirectly in connection with this post will disqualify your application.

10. Safer recruitment: Disclosure of criminal and child protection matters, Rehabilitation of Offenders Act 1974 and Criminal Records Bureau / Disclosure and Barring
Please be advised that the Directors are obliged by law to operate a checking procedure for employees who have substantial access to children and young people. In the event of a successful application, a Disclosure (‘DBS Check’) will be sought from the Criminal Records Bureau in relation to criminal and child protection matters. A conviction will not necessarily be a bar to obtaining employment. If you have been convicted of a criminal offence, the details must be provided together with any pending criminal convictions and/or pending actions of court hearings against you. Is there anything you wish to disclose at this time? Y / N If yes, please detail on a separate sheet which you will need to provide in a sealed envelope if selected for interview. The envelope will not be opened until after interviews have taken place in order to avoid prejudice.

11. Asylum and Immigration Act 1996
In accordance with the Asylum and Immigration Act 1996, if short-listed you will be required to provide documentary evidence that you are legally entitled to live and work in the United Kingdom. You must therefore provide at the interview original copies of the official documents listed in the Preventing Illegal Working – Home Office Regulations May 2004 A Guide for Candidates. Do you require a work permit to work in the UK? Y / N

12. References (To be completed by ALL applicants including those applying internally) Note: Referees should not be friends or relatives.
(i) Present/most recent employer	(ii) Previous employer If no employment history, use teacher or similar.
Name: Job title: Address: Email address (required): Telephone:	Name: Job title: Address: Email address (required): Telephone:
We reserve the right to contact referees prior to interview.

13. Driving (Answer only if relevant to mobility requirements of the post/job, or if car allowance applicable)
Have you a full current driving licence? Y / N If LGV/PCV, please state category:

14. Declaration (To be signed at interview if completed electronically)
I certify that to the best of my knowledge the information I have given is correct (providing false information or deliberately omitting relevant information will make the candidate liable to dismissal or disciplinary action if appointed). Signature: Date: