Application for Employment
Recruiting for excellence
PLEASE COPY THIS FORM AND TYPE OR WRITE CLEARLY IN BLACK INK
The Thomas Alleyne Academy and North Hertfordshire Studio School Trust are committed to
safeguarding and promoting the welfare of children, young people and vulnerable adults and our staff
share in this environment.
NAME:
POST APPLIED FOR:
POST REFERENCE:
Where did you first see this vacancy advertised?
“Where success is expected, achieved and celebrated”
STRICTLY CONFIDENTIAL
PERSONAL DETAILS
CONFIDENTIAL
PLEASE NOTE The personal details on this page remain confidential throughout the shortlisting process. The
Thomas Alleyne Academy and North Hertfordshire Studio School Trust are committed to achieving equality of
opportunity for all who work and study here, free from discrimination on the grounds of disability, gender, sexual
orientation, marital status, family responsibilities, ethnicity, race, nationality, religion, belief or age.
Title
Surname
Forenames
Address
Postcode
Phone Numbers
Home:
Daytime:
Mobile:
Email Address:
Date of Birth
NI No.
Nationality
Do you require a work permit or visa to work in this country?
Yes/No
If yes, do you already have one?
Yes/No
Expiry Date:
If no, have you applied for one?
Yes/No
Date Applied:
Do you own a car?
Yes/No
Do you have a current driving licence?
Are you related to any Thomas Alleyne Academy employee or member of the Governing Body?
If yes, please specify:
DfEE No (if applicable):
Yes/No
Yes/No
PREVIOUS EMPLOYMENT – please put most recent first
Name of Employer:
Position Held
Start Date:
Leaving Date
Please give a brief summary of the role and your responsibilities
Reason for Leaving:
Name of Employer:
Position Held
Start Date:
Leaving Date
Please give a brief summary of the role and your responsibilities
Reason for Leaving:
Name of Employer:
Position Held
Start Date:
Leaving Date
Please give a brief summary of the role and your responsibilities
Reason for Leaving:
PREVIOUS EMPLOYMENT continued
Name of Employer:
Position Held
Start Date:
Leaving Date
Please give a brief summary of the role and your responsibilities
Reason for Leaving:
Name of Employer:
Position Held
Start Date:
Leaving Date
Please give a brief summary of the role and your responsibilities
Reason for Leaving:
Name of Employer:
Position Held
Start Date:
Leaving Date
Please give a brief summary of the role and your responsibilities
Reason for Leaving:
FURTHER EDUCATION (most recent first)
College/University attended
Qualification
Subjects
Result/Grade
Subjects
Result/Grade
Organising Body
Date
SCHOOLS ATTENDED (most recent first)
School Name
Qualification
TRAINING (most recent first)
Course Title/Content
SUPPLEMENTARY INFORMATION
Please give details here of any other information you wish to be considered in support of your application. Please
state why you are interested in and suitable for the post, relating this to the job description and person specification
INTERESTS AND LEISURE ACTIVITIES
Please give details of any interests and lesisure activities which you feel may support your application.
REFERENCES
Please give names and addresses of two employment referees; one of whom should be your present or most recent employer.
We prefer to requestreferences prior to interview. Is this acceptable?
Employer 1:
Name:
Job Title:
Address:
Email:
Employer:
Name:
Address:
Email:
Job Title:
Yes
No
REHABILITATION OF OFFENDERS DECLARATION
Posts involving working with children (under the age of 18), older people, those with disabilities, learning difficulties
and other vulnerable groups are exempt from the provisions of Rehabilitation of Offenders Act 1974. If you are
applying for work in this area, you are required to state whether or not you have any convictions or criminal charges
or summonses pending against you whether or not your conviction is regarded as “spent”.
If the post has not been exempted, you must also disclose any convictions found against you which are not spent
under the terms of the Rehabilitation of Offenders Act 1974. Successful applicants will be required to have a
Disclosure & Barring Service disclosure.
We welcome applications from diverse candidates and, if you have a conviction, this will not necessarily bar you
from consideration for employment. Each case is considered according to the circumstances and background.
A failure to disclose cautions and/or convictions could result in dismissal or disciplinary action.
Have you ever received a caution or been convicted of any criminal offence?
If yes, please complete the details below including any convictions and cautions, pending
prosecutions, bind-over orders, including the appropriate date, the offence and the court of
policy force that dealt with the offence.
Approx
Date
Offence
Yes 
No 
Conviction or Pending Court or Police Force
Prosecution
dealing with Offence
Spent
(Y/N)
CONFIRMATION OF DETAILS
I hereby confirm that the information given in this application is correct to the best of my knowledge; that the
questions have been accurately and fully answered and that I am in possession of the qualifications I claim to hold.
I understand that any offer of employment is strictly subject to satisfactory references, medical clearance, school
checks and Criminal Records Bureau disclosure, and that any false statement would render me liable to
termination of employment. I understand that the information given in this application will be held on computer and
processed in accordance with the Data Protection Act 1998 and that I consent to the storage and use of such
information for employment purposes. I have read and signed the statement of data protection and data
processing.
Signature:
Date:
COMPLAINTS
If, at any stage, you feel that you have been treated in an unfair or unlawful way, please contact the
Head of Human Resources, North Hertfordshire College, Town Hall, Broadway, Letchworth, SG6 3PF
STATEMENT ON DATA PROTECTION AND DATA PROCESSING
The Data Protection Act (1998) aims to ensure that all organisations that collect, process and store
information about individuals do so correctly (ie, people about whom information is collected know of its
existence, why it has been collected and how to correct it if it is wrong).
As part of the North Hertfordshire Studio School Trust (NHSST) management processes, and in order for
the NHSST to process your application, the NHSST needs to collect process and store information about
you as contained within the application form.
Personal information contained within the application will only be used in relation to the post(s) applied
for and no other purpose. The information will be kept confidentially by the NHSST and only used by the
interview panel and Human Resources Department for the purposes of selecting the best candidate for
the vacancy.
The NHSST collects and keeps information from applicants, so that we are able to contact them, to use
in shortlisting and selection processes, and for equal opportunities monitoring purposes. We will not keep
any details of your application unless you are appointed to the post. All other information related to your
applications is disposed of confidentially within six months of the interview date for the vacancy.
If an applicant is appointed to the post, the NHSST will maintain his or her information collected for pay,
contract and management purposes, and not for any other purpose. Information will be held on computer
and on paper record in accordance with the School’s Data Protection Policy, which is issued to all
employees. Any employee has the right to request to see, and if necessary update or correct, the
information held about them by the College in accordance with this policy.
Further processing of this application is conditional upon you signing your agreement to the processing of
data for the purposes stated above.
The NHSST also requires that you clarify that all the information in your application form is accurate and
true by submitting an electronic signature. To clarify your application please provide an electronic
signature (type your name) in the space provided below.
Name:
Signature:
Date:
STRICTLY CONFIDENTIAL
EQUALITY AND DIVERSITY DATA
The Thomas Alleyne Academy and NHSST have an Equal Opportunities Policy which covers all areas of
employment, including recruitment and selection. In order to ensure the effectiveness of our policy we need the
following information, which will be treated as confidential and used for monitoring purposes only.
THE PROVISION OF THIS INFORMATION IS ENTIRELY VOLUNTARY
Ref No: (HR to complete)
Date of Birth:
GENDER
Male
Female
ETHNIC GROUP
White British
Asian Other (details below)
Any Other Group (details below)
Black British
Prefer Not to Say
White Other (details below)
Asian/Asian British
Black Caribbean
Indian
Black African
Multi-ethnic (details below)
Pakistani
Black Other (details below)
Bangladeshi
Chinese
FAITH/RELIGION
Atheist
Christian
Jewish
Sikh
Buddhist
Hindu
Muslim
Prefer Not to Say
Other (details below)
SEXUAL ORIENTATION
Heterosexual/Straight
Bisexual
Gay Man
Lesbian/Gay Woman
Prefer Not to Say
DISABILITY
Do you have a physical or mental impairment, which has a substantial effect on your ability to carry out
normal day-to-day activities?
Please give details overleaf in section on Guaranteed Interview Scheme
Yes/No
GUARANTEED INTERVIEW SCHEME
The Thomas Alleyne Academy and NHSST College are committed to the equality of opportunity for all.
To demonstrate our commitment we use the Positive About Disabled People scheme and the Disability
Symbol which is awarded by JobCentre Plus. As a scheme user, we guarantee an interview to anyone
with a disability whose application meets the minimum criteria for the post.
What do we mean by disability?
“For purpose of the Equality Act 2010 a person is considered as being disabled if they have a physical or
mental impairment which has a substantial and long term adverse effect on their ability to carry out
normal day to day activities”.
What do I need to do to ensure my application is considered under this scheme?
If you wish to be considered for interview under the Positive About Disabled People scheme then simply
complete this section and sign the declaration below.
Please give details of your disability:
Please tell us what special arrangements you would need should you be invited for interview?
We will endeavour to provide access, equipment or other practical support to ensure that people with
disabilities can compete on equal terms with non-disabled people.
Declaration:
I consider myself to have a disability, as defined above.
Name:
Signature:
Date: