Application Form

Vacancy Reference Number* Post Title*

Personal Details

Full Name* Email Address* Telephone Number Mobile Number*

Employment

Name and address of current/last employer* Nature of business* Name and address of establishment where employed (if different) Job Title* Date Appointed* Current Salary* Other Benefits (If Applicable) Hours worked per week* Notice Required (or leaving date if last appointment)* Reason for leaving or seeking other employment* Brief description of duties*

Previous Employment

Most recent first and exact dates*

	Employers name and Address	Job Title	Salary	Full or Part Time (give hours)	Date From	Date to	Reason for leaving

Please continue in the box below if necessary

Education, Training & Qualifications

Please fill out the following*

	Date From	Date To	Education Establishment	Qualifications Gained	Grade	Date Awarded

Please continue in the box below if necessary Other relevant training courses attended

	Organising Body	Course Title	Length of course

Membership of Professional Bodies

	Name of Body	Type of membership	Date obtained

Information in Support of your Application

Plese give details of any relevant information to support your application*

Referees

Please provide details of two referees below. Friends and relatives are NOT acceptable referees. One of the referees should be your present or most recent employer and normally no offer of employment will be made without a reference from them. If you have not previously been employed, then headteachers, college lecturers or other persons who are able to comment authoritatively on your educational background and/or personal qualities are acceptable as referees. References from family or friends will not be accepted. The East Midlands Education Trust reserves the right to approach any previous employer or manager.

Referee 1

Name* Status* Organisation* Address* Telephone Number* Email Address How long know for?*

Referee 2

Name* Status* Organisation Address* Telephone Number* Email Address* How Long known for* Do you give consent to us contacting your present employer prior to interview?* If no, you may wish to give reason(s)

Disclosure of Criminal Background

The Authority is required under the Police Act 1997, the Protection of Children Act 1999 and the Criminal Justice & Court Services Act 2000 to check the criminal background of those employees whose jobs give them access to children or other vulnerable members of society. Decisions to appoint will be subject to consideration of a disclosure from the Disclosure and Barring Service.

Due to the nature of the work for which you are applying, this post is exempt from the Rehabilitation of Offenders Act 1974 and therefore you must provide information about all convictions, including those which for other purposes are ‘spent’ under the Provisions of the Act

Have you ever been convicted of a criminal offence?* Have you ever been cautioned for a criminal charge?* Are you at present the subject of a criminal charge?* If YES to any of the above questions, please give brief details including dates

General

Have you ever been the subject of formal disciplinary proceedings?* If Yes, please give details You are required to declare below any relationship with or to a Trustee or member of staff within the East Midlands Education Trust. Please state name, relationship and school (if relevant): Please give details of any dates within the next 2 months when you will not be available for interview. However, if you are not available for interview on a specific date, we cannot guarantee being able to offer you an alternative date.

Health / Medical Details

Successful applicants will be required to complete a confidential medical questionnaire and may be required to undergo a medical examination.

Data Protection Privact Statement

The personal data that you provide within your application will be used for shortlisting and interviewing purposes and for contacting you about the recruitment process. If you chose to complete the sections on the final two pages of the application form, this data will be used only for monitoring purposes and will be anonymised. Your application will be stored securely and only used for purposes directly relevant to the recruitment process.

If you are appointed, your application will be placed onto a secure employment file. Details for unsuccessful candidates will be destroyed six months after the recruitment process concludes.

We do not share information about you with any third party without your consent unless the law allows us to do so.

The school is the ‘data controller’ for the purposes of data protection law.

Please specify if you are happy to give consent for your data to be used as described above*

You may withdraw this consent at any time.

Declaration

I declare that, to the best of my knowledge and belief, the information given on ALL parts of this form is correct. I understand that, should my application be successful and it is discovered subsequently that information has been falsified, then disciplinary action may be taken which may include dismissal from the post.

I confirm that I have a legal right to work in the UK and if this application is successful, I undertake to produce appropriate documentary evidence to prove this, prior to commencing work with the Trust.

If you are invited to Interview you will be required to sign a printed copy of your form.

If you have not received a reply within the next 6 weeks, you should assume that your application has been unsuccessful.

The East Midlands Education Trust is committed to safeguarding and promoting the welfare of children and young people and expects all staff and volunteers to share this commitment