RAINEY ENDOWED SCHOOL
Form: Pers1
Application for Non-Teaching Post
Applicants must complete all sections of the form in full and should not submit a Curriculum Vitae.
To facilitate photocopying please complete in BLOCK LETTERS USING BLACK INK. Additional Pages must not
be added.
Application No.
(For Official Use Only)
Post
Closing Date and Time
ICT Technician
Friday 25 March 2011 at 10.00 am
Applicants should refer to the Guidance for Applicants before completion of this form. Applicants must ensure they provide
sufficient information on the application form to enable the selection panel to assess their eligibility for consideration.
Failure to do so will result in the application being rejected.
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PERSONAL DETAILS
Surname:
Previous Surname(s):
Dr/Mr/Mrs/Ms/Miss
Forename(s)
Address:
Telephone number: (Home)
Mobile number
Postcode:
E-mail address:
Are you an EU citizen? YES/NO
Do you hold a current driving licence?
2
National Insurance No.
Do you have access to a car or other suitable form of transport if necessary to meet
the essential requirements of the post? YES/NO
YES/NO
If yes please state type of licence
QUALIFICATIONS (Original documentary evidence will be required from the successful candidate)
Subject obtained/to be taken
Level of exam
Examining Body
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Grade
Year obtained/expected
Subject obtained/to be taken
Level of exam
Examining Body
Grade
Year obtained/expected
Membership of Professional Body
Name of professional body
Qualification/Membership status (please indicate if obtained by
examination)
Date obtained
3
PRESENT EMPLOYMENT
Name and address of employer:
Position/Grade:
Date of appointment:
Annual salary/wage:
Period of notice required:
Nature of duties:
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PREVIOUS EMPLOYMENT
Name and address of
employer
Please give details of past employment (beginning with the most recent)
Job title/Grade
Period of
employment
dd/mm/yy
From
To
2
Main duties and responsibilities
Reason for
leaving
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RELEVANT INFORMATION ( IMPORTANT - PLEASE PROVIDE DETAILS OF HOW YOU MEET THE ESSENTIAL AND
DESIRABLE CRITERIA TOGETHER WITH ANY ADDITIONAL INFORMATION YOU CONSIDER RELEVANT TO THE POST)
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6
GAPS IN EMPLOYMENT HISTORY
Please account below for any time since leaving school which has not been included in previous information.
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CHILD PROTECTION (Please note this post is a ‘regulated position’ as defined under POCVA (NI) Order 2003)
(see guidance for applicants))
Is there any reason as to why you would not be suitable to work with children/young people in an educational setting?
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REFERENCES
Please give the names and addresses of two referees, one of whom should be a previous or current employer able to
comment on your suitability to work with children/young people in an educational setting (if applicable) and/or your
professional ability. The persons should not be relatives. Prior consent of referees should be obtained. References must
not be submitted with this form.
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2
Position held:
Position held:
Any person involved in the recruitment process for the post for which you are currently applying cannot act as a referee.
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DISABILITY
In accordance with the Disability Discrimination Act, a person is disabled if they have, or have had, “a physical or mental impairment
which has, or has had, a substantial and long-term adverse effect on their ability to carry out normal day-to-day activities”.
If you consider yourself to have or have had a disability that is relevant to the position for which you are applying please provide any
relevant information about your disability and your requirements that you may need so that we can process your application fairly and
make any reasonable arrangements/adjustments for your attendance at interview.
Rainey Endowed School, as part of its Equal Opportunities Policy, welcomes applications from people with disabilities.
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DECLARATION
(CANVASSING / FALSE DECLARATION / CONSENT / DATA PROTECTION)
I hereby certify and declare that:
1) The information supplied by me in this application is correct to the best of my knowledge and belief and acknowledge that if I
am appointed to the position now sought statements of material fact herein subsequently discovered to be untrue may be
considered by the Board as sufficient grounds to warrant termination of my appointment on the grounds of misconduct. I
declare that I have not canvassed in any way.
2)
I understand this post is (or may be) exempt from the provisions of the Rehabilitation of Offenders (NI) Order 1978 by virtue of
the Rehabilitation of Offenders (Exemptions) (NI) Order 1979 and (Exceptions Amendment) Order (Northern Ireland) 1987. In
the event of my application being successful, I consent to a check being made with the Police Service for Northern Ireland to
determine if there is any record of convictions, cautions or bind-overs against me;
3)
The information on this form is required by the Board for the purpose of processing your application. The information is
covered by the provisions of the Data Protection Act 1998. I understand that my signature is authorisation for the Board to
process and retain the information for the purpose(s) stated.
Signature
Date
Please complete and return this form, with the Monitoring Questionnaire and Disclosure Application Form (successful
candidate will be required to pay £30 for Enhanced check) to the address below by the date and time shown on the front of
the form. Headmaster’s Secretary, Rainey Endowed School, 79 Rainey Street, MAGHERAFELT, BT45 5DB
LATE APPLICATIONS WILL NOT BE CONSIDERED
The Board of Governors of Rainey Endowed School reserves the right not to appoint.
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RAINEY ENDOWED SCHOOL
EQUAL OPPORTUNITIES QUESTIONNAIRE
NON –TEACHING JOB APPLICANTS
DO NOT SEPARATE THIS QUESTIONNAIRE FROM THE APPLICATION FORM
PLEASE READ THE NOTES ON REVERSE BEFORE COMPLETING THIS QUESTIONNAIRE
An equal opportunities questionnaire must be completed, in full and returned with the application form.
PLEASE COMPLETE THE FOLLOWING SECTIONS: TICK BOXES AS APPROPRIATE
1.
SEX
MALE
FEMALE
2.
MARITAL STATUS:
SINGLE
MARRIED
WIDOWED
3.
DATE OF BIRTH
4.
DISABILITY
DIVORCED
OTHER/SPECIFY__________
___________________
Do you consider yourself to have a disability?
YES
NO
If yes, please indicate the nature of your disability by ticking the appropriate box(es).
5.
6.
MOBILITY
DEXTERITY/CO-ORDINATION
VISION
PSYCHIATRIC/MENTAL
HEARING
LEARNING
SPEECH
OTHER (Please specify): _____________________
RACE/ETHNIC ORIGIN:
WHITE
CHINESE
IRISH TRAVELLER
INDIAN
BLACK AFRICAN
BLACK CARIBBEAN
PAKISTANI
BANGLADESHI
OTHER (specify) ______
FAIR EMPLOYMENT MONITORING INFORMATION
Please indicate the community to which you belong:
I belong to the Protestant Community
I belong to the Roman Catholic Community
I belong to neither the Protestant nor Roman Catholic Community
NB. This questionnaire should be returned with the application form to the
Headmaster’s Secretary (the correct postage should be paid).
THANK YOU FOR YOUR
CO-OPERATION.
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EQUAL OPPORTUNITIES MONITORING
It is the policy of the Board of Governors of Rainey Endowed School that all eligible persons will have equal
opportunity for employment and advancement in the Board, irrespective of perceived religious belief, political
opinion, gender, disability, age or race.
Selection for employment and advancement will be on the basis of ability, qualifications and aptitude to carry
out the duties of the post.
In order to fulfil its legal obligation under the Fair Employment and Treatment (NI) Order 1998 and to ensure
that its Equal Opportunities Policy Statement is effectively implemented, the Board of Governors of Rainey
Endowed School is monitoring job applicants. Monitoring involves a comparison of recruitment and career
progression of applicants with regard to sex, marital status, perceived religious affiliation and disability.
Access to this information will be strictly controlled and will not be available to those considering your
application for employment. Monitoring will involve the use of statistical summaries of information in which
the identities of individuals will not appear. This information will not be available for any purpose other than
Equal Opportunities Monitoring. While the Board of Governors will seek to maintain the confidentiality of all
documentation relating to appointments, disclosure of documentation may be required under the provisions of
the equality legislation applicable in Northern Ireland.
It should be noted that it is an offence, under the Fair Employment and Treatment (NI) Order 1998 to give
false information to an employer who is seeking information from job applicants.
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