ST MARTIN’S SCHOOL, NORTHWOOD

?ST MARTIN’S SCHOOL, NORTHWOODHead of Maths Appointment – Application FormPLEASE COMPLETE IN BLACK INKYou are requested to complete this form (using supplementary sheets if there is insufficient space for any entry): if you wish to submit a curriculum vitae, in addition, you may do so.PERSONAL DETAILS (block capitals please)Surname/Family NamePreferred TitleFirst Name(s)Home AddressPresent Address (if different) Postcode PostcodeTelephone (Home)Telephone (Work) (Mobile)E-mailDfES reference numberCURRENT EMPLOYMENTName of EstablishmentType of School*Number on Roll Age-rangePost HeldDate AppointedTotal Annual SalaryFull/Part-Time(if P/T show fraction of Full-Time e.g.?,?Grade or Allowance*eg Primary, Voluntary Aided, Girls/Boys, Comprehensive, IndependentPREVIOUS EMPLOYMENT DETAILSPlease list in chronological order, with precise dates if possible. For periods of part-time employment the fraction of full-time should be shown (e.g. ?, ?) or the average hours per week for hourly paid appointments.a) IN EDUCATION (“Supply” teaching appointments need not be listed individually)EstablishmentPost and GradeType ofSchoolNumberOn RollAgeRangeF/T orP/TFrom(Month& Year)To(Month & Year)b) OUTSIDE EDUCATIONEstablishmentPost F/T or P/TFrom (Month& Year)To (Month & Year)HIGHER EDUCATIONEstablishment(s)FromToFull orP/TimeQualification AwardedDegreeClass DivisionDate of AwardDegreeor Cert Ed.Age-range for which trainedPGCESubject(s)Other (state)SECONDARY SCHOOL EDUCATIONEstablishment(s)FromToPlease give details of ‘A’ LevelsOTHER QUALIFICATIONS OBTAINEDCourse and Organising BodyDateQualificationPERIODS NOT ACCOUNTED FOR IN PREVIOUS SECTIONS SINCE AGE 18 (please give details)From (Month& Year)To (Month & Year)IN-SERVICE TRAININGPlease give details of courses relevant to this post attended within the last three yearsCourseDateReferencesPlease give the names, addresses and status of two referees who may be approached now.(If you are currently employed as a teacher one reference should normally be your present Head)NameStatusAddressTelephoneE-mail PostcodeNameStatusAddressTelephoneE-mail PostcodeCRIMINAL CONVICTIONSThe post for which you have applied is exempt from the provisions of the Rehabilitation of Offenders Act 1974 (Exceptions) (Amendments) Order 1986. You are required to disclose details of any criminal convictions, cautions or bind-overs. In so doing you will be deemed to have given your permission for a Police check to be carried out.In the event of being employed any failure to disclose such convictions could result in dismissal or disciplinary action. The information given will be completely confidential. Please list details (i.e. type of offence, date, sentence, fine imposed etc.) below or state none.N.B Further The post for which you are applying provides access to children you are therefore required to discuss details on a separate form (Ref Criminal Disclosures CB1 or CB2)Please note that an application will not be considered further if the candidate declines to complete the Criminal Disclosure SectionI have read and understood the candidate information and job description for this post and I hereby certify that the information given above is correct to the best of my knowledgeSignatureDateCOVERING LETTERYou are asked to submit a brief covering letter outlining your motivations for applying for the post and outlining how you feel you meet the job description and person specification. ................
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