A University Technical College
Specialising in:
Electrical and Mechanical Engineering, Advanced
Manufacturing
APPLICATION FOR PRINCIPAL
APPOINTMENT
UTC PORTSMOUTH
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Guidance on completing this form
This form is designed to enable candidates to demonstrate the extent to which their
experience to date meets the needs of the UTC Trust.
We do not expect candidates to complete all the sections.
1. Please note that no curriculum vitae or letter of application is required, unless
specified by the school.
2. Canvassing, directly or indirectly, will disqualify.
3. Teachers aged 55 and over are advised that, if they have previously accepted early
retirement from a teaching post, and, if appointed to a new post, they should advise
the Paymaster General, the Department of Education and their previous employer
of their change of circumstances.
4. In line with the Equality Act 2010 and the Education (Health Standards) (England)
Regulations (2003) the successful candidate will be required to complete a medical
questionnaire, and may then be required to undergo a medical examination.
When complete, this form should be e-mailed to UTC Portsmouth Project Manager:
enquiries@utcportsmouth.org
5. Candidates should ensure that, as far as possible, referees named are able to
comment on their achievements and on their knowledge and understanding of
current educational issues.
6. For candidates in LA schools, it is expected that the Head of Education should be
named as one of your referees. It is UTC Portsmouth guidance to take up LA
references as a matter of course for LA schools.
7. The application form should be completed in Arial font (no smaller than size 11);
alternatively it may be completed by hand, and for ease of photocopying, in Black
Ink and use BLOCK CAPITALS1.
This application form is available electronically at www.utcportsmouth.org where
you will find more information on the UTC, follow the link to vacancies.
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Applications completed by hand should be sent to: UTC Portsmouth Project
Manager | c/o Ms Natalie Cleife | Human Resources | Floor 1, University House
| Winston Churchill Avenue| Portsmouth | PO1 2UP
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Application for the post of UTC Portsmouth Principal
Section One - Personal Details
Surname:
Title Mr/Mrs/Miss/Ms or other:
Forename:
Former names (if applicable):
Home address:
Postcode:
Telephone number (Home):
(Work):
Mobile Telephone number:
Email address:
Please state your preferred method for us to contact you during the working day:
Work telephone / mobile telephone / email address (delete as appropriate)
Teacher Reference Number (DfE
National Insurance Number:
number):
If you are not a European Citizen, please state if you require a work permit: Yes / No
If yes, please specify your circumstances:
Do you hold Qualified Teacher Status?
If Yes, please give date of the award.
QTS Certificate number (if available)
Have you successfully completed a period of
induction as a qualified teacher in this country
where the DfE required this?
Yes / No
Do you hold NPQH?
If Yes, please give date of completion, and LA
where induction was completed:
Yes / No
If Yes, please give date awarded:
Are you subject to any conditions or prohibitions placed on you by the DfE National College for
Teaching and Leadership (NCTL) (or any other body in the UK)?
If Yes, give full details (continuing on additional sheet as required)
Do you have an enhanced DBS (CRB) check completed in the last two years? Yes / No
If yes, please give DBS (CRB) reference number, date completed, and LA check completed
by:
Are you currently registered with the DBS Update Service? Yes / No
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Section Two - Current Employment
Current Post Details:
Job title:
Employers name and address:
Telephone number:
Email address:
Date appointed:
Grade/allowances:
Date available to take up post:
NOR:
Leadership point:
Salary:
Section Three – Confidential References
Name, address, telephone number, Email address and status of THREE referees. If you
currently work for a Local Authority one of which must be an LA reference. If you currently
work for an academy then an equivalent reference to an LA reference is required.
References will be taken up before interview. References will not be accepted from
relatives or from people writing solely in the capacity of friends
1)
Telephone Number:
Mobile Number:
Email address:
2)
Telephone Number:
Mobile Number:
Email address:
3)
Telephone Number:
Mobile Number:
Email address:
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Section Four – Education/Qualification Details
Please provide information below relating to post 16 education.
School/College/University
(Name & Address)
Subject(s)
Level (e.g.
A Level,
Degree
etc)
Grade
Date Gained
Section Five – Details of Further Training
Please list any training/professional development you have received in the last three years
which has helped you to prepare for/undertake the role of Principal (including collaborative
work/work with other organisations relevant to this post):
Title of Course/Nature of
Development Opportunity
Duration of
Training/Development
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Brief outline of
Course/Development
Opportunity
Date(s)
Section Six - Career Record
Please list in unbroken chronological order, all posts that you have held since leaving school, including those outside education, with an
explanation of any breaks. Please start with the most recent post. Please ensure you have included a month and year in the date from
and date to boxes.
Date
From
Date
To
Name of
employer
Name and type of school/college
Approx. NOR
(If appropriate)
(If appropriate)
Include age range and whether mixed
or single sex
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Post Title, Grade
or Scale (Full or
part time)
Reason for leaving or break in
appointment
Section Seven – Periods of Non-Employment
From
To
Reason
In the following sections (eight and nine) Candidates are invited to
provide information about how they meet the job specification in
section 8 (provided with the application pack), and are invited to set out
their vision for the UTC in section 9; separate letters of application are
not required.
Section Eight - Personal Statement
Please provide, on no more than two sides of A4 (Arial font, minimum point
11) further evidence and information related to the job description and person
specification that concentrates on your key skills and achievements, and
provides evidence of outcomes and impact in line with the national standards
of excellence for Headteachers/Principals. (Do not attach a CV as it will not
be considered).
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Section Nine - Vision and any other information
Please set out in the box below your vision for the UTC and outline how you would
successfully lead this school, alongside any further information you feel would be helpful to
us in considering your application and Maximum of one side of A4. (Arial font, minimum
point 11).
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EMPLOYMENT CHECKS
Rehabilitation of Offenders Act 1974(Exemptions) Order 1975
Teaching with the privileged access it gives to children is an exempted occupation under
the Rehabilitation of Offenders Act 1974 (Exemptions) Order 1975. You are therefore
required to declare any criminal convictions, cautions, reprimands or final warnings
including those that are 'spent'. The amendments to the Exceptions Order 1975 (2013)
provide that certain 'spent' convictions and cautions are 'protected' and are not subject to
disclosure to employers, and cannot be taken into account. Guidance and criteria on the
filtering of these cautions and convictions can be found on the Disclosure and Barring
Service website: www.gov.uk/dbs.
Do you have any convictions, cautions, reprimands or final warnings that are not
"protected" as defined by the Rehabilitation of Offenders Act 1974 (Exceptions) Order
1975 (as amended in 2013)?
Yes
No
If YES, please give details of any convictions (and the dates) on a separate piece of paper
and place in a sealed envelope marked for the attention of the Chair of the Panel.
Portsmouth Local Authority is committed to safeguarding and promoting the welfare of
children and young people and expects all staff and volunteers to share this commitment.
If you are ultimately offered the position you will be required to undergo an Enhanced DBS
check, and will be asked to complete an application form, or provide information to allow
the school to check your status on the DSB Update Service.
With effect from 17th June 2013 DBS certificates will only be issued directly to the
applicant. You will be required to show your certificate to the employing school who will
record the Disclosure number and issued day and retain on your personnel record. In line
with the DBS Code of Practice the school will not take and retain photocopies of the full
DBS Certificate.
Please state where you saw the advertisement for this post:
Please state, whether to the best of your knowledge, you are related to a member of the
UTC Portsmouth Project Steering Group. If YES, please state the nature of the
relationship and the name.
No:
Yes:
I understand that if I am appointed, personal information about me will be computerised for
personal/employee administrative purposes including analysis for management purposes
and statistical returns.
I confirm that I am not on The Children’s Barred List (previously List 99 and PoCA List),
disqualified from working with children, or subject to sanctions imposed by a regulatory
body, e.g. the DfE National College for Teaching and Learning. I either have no
convictions, cautions, or bind-overs, or have attached details of recorded offences in a
sealed envelope marked confidential.
The information on this form is correct and complete to the best of my knowledge and
belief.
Signature of candidate
Date …………………..
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Name ................................................................. Post applied for ...............................
Post No ...............
EQUAL OPPORTUNITIES – MONITORING SUPPLEMENT (Please  appropriate box)
Date of Birth …………….
Age …………
Previous last names………………..
Do you wish to apply for this post on a job share basis?
Yes/No
Do you have a disability? Yes/No
What special adaptations might you need to carry out the job/attend for interview?
......................................................................................................................................................................
......................................................................................................................................................................
......................................................................................................................................................................
Ethnic Origin
How would you describe your ethnic origin? (For this purpose “ethnic origin” means a person who
themselves, or whose parents and/or grandparents were born within one of the groups below)
a) White
British/Irish/Any other white background (please state) ……………………… (delete as
appropriate)
b) Mixed
White and Black Caribbean/White & Black African/White & Asian/Any other mixed
background (please state) ……………………… (delete as appropriate)
c) Asian or Asian British
Indian/Pakistani/Bangladeshi/Any other Asian background (please state) ……………………
(delete as appropriate)
d) Black or Black British
Caribbean/African/Any other black background (please state) ……………………… (delete
as appropriate)
e) Chinese or other ethnic group
Chinese/Any other (please state) ……………………… (delete as appropriate)
f) I do not wish to give this information
Religion
a) None / Christian (inc Church of England, Catholic, Protestant and all other Christian
denominations) / Buddhist / Hindu / Muslim / Sikh / Jewish / Other (please state)
……………………… (delete as appropriate)
b) I do not wish to give this information
How did you find out about this job?
Newspaper / professional Journal / Word of mouth / other (please specify) ………………………
(delete as appropriate)
THIS PAGE IS CONFIDENTIAL AND WILL NOT BE SEEN BY THE SELECTION PANEL
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