CHURCH OF ENGLAND - DIOCESE OF SOUTHWARK

TEACHER OF ART APPLICATION

CONFIDENTIAL
SOUTHWARK DIOCESAN
BOARD of
EDUCATION
NAME OF SCHOOL: Christs School
Closing date for completed form: !"# T$%s&!'# ()
th
*$+% (,-)
Return form to: jralphchrists.richmond.sch.uk
Christs School,
Richmond,
Surrey
TW1 !"W
to #hom all $ueries should %e addressed &rs 'ulia Ralph
(lease state #here you
sa# the ad)ertisement
for this post:
- APPLICANT.S PERSONAL DETAILS
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( TEACHER STATUS
3o you ha)e 7ualified Teacher Status
/re there any restrictions on your residence or employment in the 048 6es .o
*f 6es, please gi)e details
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/ SUPPORTING STATEMENT
With reference to the ;o)ernors< selection criteria, please gi)e details of your e=perience, skills, a%ilities and
personal $ualities that you %elie)e are rele)ant to your suita%ility for the post and indicate ho# you meet the person
specification. /lso pro)ide any additional information #hich you think #ould %e useful in this jo%. (lease #rite this on
a separate sheet>s? of paper.
) PRESENT OR MOST RECENT EMPLO0MENT
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1 PRE2IOUS TEACHING EMPLO0MENT 3st!rt 4ith "ost r%c%+t 5 6l%!s% %76l!i+ !+' 8!6s i+ %"6lo'"%+t9
School, college or other employer Type @ status of
esta%lishment
/ge
range
and roll
>appro=?
Title of post >include special
responsi%ilities?
3ates of
employment
:
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: EDUCATION AND ACADEMIC ;UALIFICATIONS
School9college9uni)ersity -rom To Su%jects97ualifications9;rades9"onours,
dates a#arded and a#arding %ody
Secondary >post 1!?
"igher ,ducation
-urther postgraduate $ualifications
>including (;C,?
< IN-SER2ICE TRAINING UNDERTAKEN DURING THE PAST / 0EARS RELE2ANT TO THIS APPLICATION
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Course title (ro)ider 3ates @ duration of
course
/#ard >if any?
= OTHER PAID WORK E>PERIENCE 36l%!s% %76l!i+ !+' 8!6s i+ %"6lo'"%+t9
,mployer -rom To .ature of 2ccupation
DETAILS OF OTHER ACTI2ITIES# SKILLS AND INTERESTS RELE2ANT TO THIS POST
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-, RELIGIOUS AFFILIATION
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3etails of your $ualifications and e=perience #hich you feel are especially rele)ant to teaching in a Church of
,ngland school, not included in your supporting statement. Where appropriate, please include details of a Christian
or other faith commitment and any centre of #orship you regularly attend.
-- PROFESSIONAL REFERENCES - 6l%!s% s$66l' th% +!"%s !+& !&&r%ss%s o? t4o 6%rso+s 4illi+8 to 6ro@i&%
r%?%r%+c%sA O+% sho$l& B% ?ro" 'o$r c$rr%+t H%!&t%!ch%rA I? 'o$ !r% +ot c$rr%+tl' 4orCi+8 4ith chil&r%+# !
r%?%r%+c% ?ro" th% %"6lo'%r B' 4ho" 'o$ 4%r% "ost r%c%+tl' %"6lo'%& to 4orC 4ith chil&r%+ 4ill B% r%D$ir%&A
R%?%r%+c%s 4ill +ot B% !cc%6t%& ?ro" r%l!ti@%s or 6%o6l% 4riti+8 sol%l' i+ th% c!6!cit' o? ?ri%+&sA
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(lease state the conte=t in #hich this person is kno#n to yourself:
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-( DECLARATION E0 APPLICANT
* understand that appointment to this post is su%ject to a satisfactory ,nhanced Criminal Records 5ureau
disclosure. * also understand that, under the terms of the Reha%ilitation of 2ffenders /ct 1DEB >,=ceptions 2rder
1DEC, and su%se$uent amendments?, * am re$uired to disclose any record * may ha)e of criminal con)ictions,
cautions and %indFo)ers, including those regarded as Gspent and to attach details of the same.H
"a)e you a record of criminal con)ictions, cautions or %indFo)ers8 6es >details attached? .o
H (lease note information a%out criminal con)ictions, cautions and %indFo)ers #ill remain confidential %ut #ill %e
made a)aila%le to the panel for consideration if your application is other#ise deemed #orthy of shortFlisting.
* declare that * am not on +ist DD, or dis$ualified from #orking #ith children, or su%ject to any sanctions imposed %y
a regulatory %ody >i.e. the ;eneral Teaching Council?
* understand that under the terms of the *mmigration, /sylum and .ationality /ct :!should * %e shortFlisted for
the post for #hich * am applying, * #ill pro)ide for the go)erning %ody, as employer, an original documentH sho#ing
my entitlement to #ork in this country.
H/ccepta%le documents include your .ational *nsurance card, a %irth certificate issued in the 04 or ,ire, a (BC from your
pre)ious employer, a )alid passport, or any rele)ant authorisation allo#ing you to #ork in this country.
* appreciate that * must declare any family or close relationship #ith a mem%er of the school<s ;o)erning 5ody, an
employee of the school or senior official of the local education authority #hich has responsi%ility for the school. *
understand that failure to disclose such a relationship may result in my dis$ualification.
* certify that all information gi)en %y me on each section of this form and in supporting documents is correct to the
%est of my kno#ledge and %elief, that all $uestions ha)e %een fully and accurately ans#ered, and that * possess all
$ualifications #hich * claim to hold and #ill produce e)idence of the same. * ackno#ledge that * ha)e read,
understand and #ill comply #ith the .otes to /pplicants #hich accompanied this application form.
* understand that my name #ill %e #ithdra#n from the list of candidates if, prior to appointment, * am found
kno#ingly to ha)e omitted or concealed any rele)ant fact, and * ackno#ledge that such disco)ery su%se$uent to
appointment is likely to lead to my dismissal #ithout notice and, #here appropriate, referral to the police.
* here%y consent to the processing of sensiti)e personal data, as defined %y the 3ata (rotection /ct 1DDI, in)ol)ed
in the consideration of this application.
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ADDITIONAL INFORMATION 3CONFIDENTIAL9 - This s%ctio+ o? th% ?or" s%%Cs !&&itio+!l i+?or"!tio+
6%rti+%+t to 'o$r !66lic!tio+A It 4ill B% r%"o@%& B%?or% shortlisti+8 !+& 4ill +ot B% s%%+ B' !+' "%"B%rs o? th%
s%l%ctio+ 6!+%lA Acc%ss to it 4ill B% li"it%& to st!?? i+@ol@%& i+ !&"i+ist%ri+8 th% !66oi+t"%+t 6roc%ss 4ho +%%&
!cc%ss ?or %D$!l o66ort$+iti%s "o+itori+8 or to t!C% !&"i+istr!ti@% !ctio+ B!s%& $6o+ th% i+?or"!tio+ 6ro@i&%&
%A8A Occ$6!tio+!l H%!lth r%?%rr!l
Positio+ !66li%& ?or:
Title: -irst name: Surname:
3ate of %irth:
/re there any reasona%le adjustments you #ould like us to make to ena%le you to participate fully and fairly in the
recruitment process8
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*f 6es, please gi)e details:
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E;UAL OPPORTUNITIES MONITORING - 4% 4ish to "o+itor co+ti+$o$sl' 3i+ th% strict%st co+?i&%+c%9 th%
6ro8r%ss o? o$r ED$!l O66ort$+iti%s Polic'A Pl%!s% h%l6 $s B' 8i@i+8 th% ?$ll%st 6ossiBl% !+s4%rs to th%
D$%stio+s B%lo4A
S%7: & - A8%: :F:D AFAD BFBD CFCD !F!C
* consider myself to %e disa%led #ithin the meaning of the 3isa%ility 3iscrimination /ct 1DDC
Pl%!s% i+&ic!t% 'o$r c$lt$r!lF%th+ic ori8i+s
This information is included as part of the duty of the school to promote race e$uality and to ensure e$ual
opportunities for all staff and is recommended %y the Commission for Racial ,$uality >###.cre.go).uk?.
White
5ritish
,nglish
Scottish
Welsh
2ther: please #rite in
*rish
/ny other White %ackground: please #rite in
Black, Black British, Black English, Black Scottish or Black Welsh
Cari%%ean
/frican
/ny other 5lack %ackground: please #rite in
Asian, Asian British, Asian English, Asian Scottish or Asian
*ndian
(akistani
5angladeshi
/ny other /sian %ackground: please #rite in
Mixed
White @ 5lack Cari%%ean
White @ 5lack /frican
White @ /sian
/ny other &i=ed %ackground: please #rite in
Chinese, Chinese British, Chinese English, Chinese Scottish or Chinese Welsh or other ethnic group
Chinese
/ny other %ackground: please #rite in
Prefer not to state
Put a cross here if you prefer not to state your ethnic group
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Not%s to !66lic!+ts
5efore signing this form please check that e)ery section has %een completed.
The form should %e returned as instructed in the details of the post.
,nclose a stamped addressed en)elope if you #ish us to ackno#ledge your application.
6ou are reminded that this is an application form for a post in a Church of ,ngland9Church in Wales 1oluntary
/ided school or a -oundation school in #hich the ;o)erning 5ody is the employer. *f you are appointed the
Contract you #ill %e asked to sign #ill include the follo#ing clause >the second paragraph is omitted in the case of
a -oundation school or #here you are not re$uired to gi)e religious education?:
o /s a teacher in a Church of ,ngland9Church in Wales school you are re$uired to ha)e regard to the
Christian character of the school and its -oundation and to undertake not to do anything in any #ay
contrary to the interests of the -oundation.
o 6ou are re$uired to gi)e and9or super)ise the gi)ing of religious education in accordance #ith the
doctrines of the Church of ,ngland9Church in Wales and Trust 3eed of the School. 6ou are re$uired to
take part in and lead acts of religious #orship.
The successful applicant #ill %e re$uired to pro)ide an ,nhanced 3isclosure from the CR5.
Details of referees
2ne referee should %e your current or most recent employer. *f you are not currently #orking #ith children %ut
ha)e done so in the past, a reference #ill %e re$uired from the employer %y #hom you #ere most recently
employed in #ork #ith children.
The school #ill seek references on shortFlisted candidates, and may approach pre)ious employers for information
to )erify particular e=perience of $ualifications, %efore the inter)ie#.
*f you are currently #orking #ith children, on a paid or )oluntary %asis, your current employer #ill %e asked a%out
disciplinary offences relating to children, including any penalty #hich is time e=pired and #hether you ha)e %een
the su%ject of any child protection concerns, and if so, the outcome of the en$uiry or disciplinary procedure. *f you
are not currently #orking #ith children %ut ha)e done so in the past, the rele)ant pre)ious employer #ill %e asked
a%out those issues.
References from relati)es or friends #riting solely in the capacity of friends #ill not %e accepted.
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