University of Reading – Assessment Only for QTS
Application Form 2014-15
The University of Reading cannot evaluate your application unless you have provided evidence that you have the
necessary qualifications and that the school provides a suitable environment for assessment to enable you to reach
the Standards for the award of Qualified Teacher Status (QTS).
The University of Reading cannot approve your application until all declarations have been signed, and all
necessary information and supporting documents received.
The information on the form will be stored on a database for up to three years and is subject to the Data Protection
Act. The National College for Teaching and Leadership (NCTL) will have access to the database. Information on
all candidates may also be made available to Ofsted. The NCTL and The University of Reading may use
anonymised data for statistical analysis.
Your application will comprise the following documents:

Application Form including ‘Front Sheet’ with Declaration of Accuracy

Evidence of your DBS clearance

Copy of your degree certificate*

Copy of your GCSE Grade C equivalent Mathematics and English qualifications*

Copy of your GCSE Grade C equivalent Science qualification if you are a primary teacher
*You will need to have the original certificates available for the University Assessor at
the Initial Visit.
Your completed application with all required documents should be sent to:
AO Administrator
Institute of Education
University of Reading,
London Road
Reading RG1 5EX
1
University of Reading AO Application Form 2014-15
Front Sheet
Applicant Name:

School:

I have achieved a standard equivalent to a grade C in the GCSE examination in Mathematics
I enclose a copy of my Mathematics qualification certificate
I have achieved a standard equivalent to a grade C in the GCSE examination in English
I enclose a copy of my English qualification certificate
(Primary applicants only) I have achieved a standard equivalent to a grade C in the GCSE
examination in a science subject.
(Primary applicants only) I enclose a copy of my science qualification certificate
I have a UK first degree or equivalent qualification
I enclose a copy of my degree qualification certificate
I enclose the reference number of my DBS clearance
If you have not achieved a standard equivalent to a grade C in the GCSE examination in English or
Mathematics, it may be possible for you to take an equivalence test at The University of Reading.
Applicant Declarations
 I confirm that all the information I have provided on all documents is accurate.
 I understand that information in this application may be stored on a database and made
available to the Department for Education.
Signature:
Date:
2
AO Applicant Information
I wish to apply for:
Age ranges (circle two consecutive): 3-5 5-7
7-9
9-11
11-14
14-1616-19
Secondary subject: ___________________
Title (circle)
Mr / Mrs / Miss / Ms / Dr
Other____________
Gender (circle) Male / Female
Forenames (in full)
Surname
Previous Surname
(if applicable)
Marital Status (circle)
Married / Single / Divorced / Widowed
Correspondence address
Postcode:
Phone numbers (h, w, m)
E-mail
Date of Birth
National Insurance
Number
____ ____ ____ ____ ____ ____ ____ ____ ____
Nationality
Country of Birth
Please indicate your ethnic group so that the University of Reading can monitor equal
opportunities.
3
White British
Black or Black British,
Caribbean
Black or Black British, African
Asian or Asian British, Indian
Other Asian background
Asian or Asian British,
Pakistani
Other Black background
Asian or Asian British,
Bangladeshi
Chinese or Other Ethnic background – Chinese
Mixed, White & Black
Caribbean
Mixed, White and Black
African
Other Mixed background
Other ethnic background
Not known
Information refused
White Irish
White Other
Qualifications
Please give details of GCSEs or equivalent qualifications and when they were obtained. All candidates for QTS
must have attained the standard required for GCSE grade C in English and Mathematics before they start their
programme. Candidates who will be teaching the primary age range must also have attained the standard required
for GCSE grade C in Science. Equivalence test results are acceptable.
4
Provide details of your undergraduate and any higher degree (MA, PhD) qualifications.
State exact name of qualification(s), title/subject of degree, degree classification, awarding
institution, start and finish dates of study and date of award.
List ALL formal pre-degree qualifications undertaken.
State exact name of qualification(s), and subject, grade, and date for each.
You are required to provide a copy of the transcript/statement for English, Mathematics and
Science GCSE equivalence.
Do you have a disability or recognised learning difficulty (eg dyslexia)? YES/NO
If yes, please give further details here
AO Teaching Experience
Attach a list of your teaching experience, including your current position.
For Primary, state Year group(s) taught; number of children in each class; if part-time, percentage of
time working as a teacher. If relevant, attach your teaching timetable.
For Secondary, attach your teaching timetable showing subject(s) and Year groups taught. If part-time,
give percentage of time working as a teacher.
5
Include the following information for all the schools in which you have taught:
Name of School/college
Country
Post held
Dates of service
If part-time, percentage of time
working as a teacher
From
to
Please tick the box(es) that best describe the school:
 State Primary
 State Secondary
 Independent
 Special
 Other (please specify)
Age range of pupils taught
Subjects taught
%
6
AO School Information Form
Name of School
Please tick the box(es) that best describe the school
Primary
Special
Name of Headteacher
Secondary
Independent
Other (please specify)_____________________
Name of School CPD Coordinator/Professional Tutor
& email address
Name of Designated Mentor
& email address
School address
Postcode:
Phone number
E-mail
School’s experience of QTS assessment
Has the school previously worked with a University of Reading ITT or AO candidate?
YES/ NO
Is the school currently a University of Reading Partnership School?
Is the school currently a Partnership School with another institution?
Has the school had experience of QTS candidates through another provider?
YES / NO
YES / NO
YES/ NO
If yes, please specify route: AO/BA/PGCE/GTP/OTTP; Institution(s):
Mentor’s Experience of ITT
Please give details of mentor’s experience (e.g. GTP, PGCE, inc. dates)
Has the mentor undertaken any mentor training? YES / NO
(if YES please indicate through which institution)
…………………………………………………
School Declarations
7
I confirm that the Assessment Only teacher to whom this application refers will work as a
teacher at this school during the period up to and including the date of Final Assessment
I confirm that the appropriate health and DBS checks on the teacher to whom this
application refers have been carried out
I confirm that the school wishes to support this application, in keeping with the
partnership outline (below), and will undertake the necessary support for this teacher up to
and including the date of Final Assessment
I confirm that the school will inform the teacher about the relevant statutory arrangements
for the induction of newly qualified teachers.
Signature of Headteacher: ___________________________
Name (please print): _________________________________
Date: _____________________
The AO partnership
Selection and
interviewing
Assessment
QA
Equal ops &
safeguarding
School staff
Support of AO
application
Lesson observations &
final report
Teacher’s AO
evaluation
Responsibilities of the
school as employer
UoReading staff
Interview at initial visit
External examiner
Lesson observations
and final interview
Self-evaluation and
improvement planning
Sample of final
assessment
Report feeds into
improvement planning
8